Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

High Bleeding Risk & DES Use in ACS Patients

Am J Cardiol; ePub 2017 Jul 24; Alraies, et al

The presence of high bleeding risk (HBR) has a significant impact upon the decision to use drug-eluting stents (DES) in patients presenting with acute coronary syndrome (ACS), a recent study found. The study evaluated the likelihood of receiving DES during percutaneous coronary intervention (PCI) in HBR populations and identified consecutive patients who underwent PCI from April 2003 to September 2015. HBR was defined as patients fulfilling ≥1 of the HBR criteria: age ≥75 years, anticoagulation use at discharge, history of stroke, cancer in previous 3 years, glucocorticoid use, hemoglobin <11 g/dL, platelet count <100,000/mm3, or creatinine clearance (CCr) <40 ml/min. Researchers found:

  • 10,5954 patients met HBR definition.
  • Patients with HBR were less likely to receive a DES compared with non-HRB patients (OR, 0.58).
  • A preprocedure hemoglobin <11 g/dL had the greatest association with choosing DES during PCI (OR, 0.51).
  • Patients having ≥3 HBR criteria had lower likelihood of receiving a DES.


Alraies MC, Lee SY, Lipinski MJ, et al. Effect of bleeding risk on type of stent used in patients presenting with acute coronary syndromes. [Published online ahead of print July 24, 2017]. Am J Cardiol. doi:10.1016/j.amjcard.2017.07.013.

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Barriers to Healthcare Access After an ACS, Am J Cardiol; ePub 2018 Jul 15; Erskine, et al

LOS After Non-ST-Segment Elevation Acute MI, Am Heart J; ePub 2018 Apr 19; Rymer, et al

Ischemic Events in Patients with PAD After an ACS, Am Heart J; ePub 2018 Mar 28; Inohara, et al

Outcomes in Patients with ACS Due to LMCAD , Am Heart J; ePub 2018 Feb 22; Gharacholou, et al

Adherence Rates to Secondary Prevention Meds, Circulation; ePub 2018 Jan 31; Mathews, et al