Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention

Philip Urban, Roxana Mehran, Roisin Colleran, Dominick J. Angiolillo, Robert A. Byrne, Davide Capodanno, Thomas Cuisset, Donald Cutlip, Pedro Eerdmans, John Eikelboom, Andrew Farb, C. Michael Gibson, John Gregson, Michael Haude, Stefan K. James, Hyo Soo Kim, Takeshi Kimura, Akihide Konishi, John Laschinger, Martin B. LeonP. F.Adrian Magee, Yoshiaki Mitsutake, Darren Mylotte, Stuart Pocock, Matthew J. Price, Sunil V. Rao, Ernest Spitzer, Norman Stockbridge, Marco Valgimigli, Olivier Varenne, Ute Windhoevel, Robert W. Yeh, Mitchell W. Krucoff, Marie Claude Morice

Research output: Contribution to journalReview articlepeer-review

419 Scopus citations


Identification and management of patients at high bleeding risk undergoing percutaneous coronary intervention are of major importance, but a lack of standardization in defining this population limits trial design, data interpretation, and clinical decision-making. The Academic Research Consortium for High Bleeding Risk (ARC-HBR) is a collaboration among leading research organizations, regulatory authorities, and physician-scientists from the United States, Asia, and Europe focusing on percutaneous coronary intervention-related bleeding. Two meetings of the 31-member consortium were held in Washington, DC, in April 2018 and in Paris, France, in October 2018. These meetings were organized by the Cardiovascular European Research Center on behalf of the ARC-HBR group and included representatives of the US Food and Drug Administration and the Japanese Pharmaceuticals and Medical Devices Agency, as well as observers from the pharmaceutical and medical device industries. A consensus definition of patients at high bleeding risk was developed that was based on review of the available evidence. The definition is intended to provide consistency in defining this population for clinical trials and to complement clinical decision-making and regulatory review. The proposed ARC-HBR consensus document represents the first pragmatic approach to a consistent definition of high bleeding risk in clinical trials evaluating the safety and effectiveness of devices and drug regimens for patients undergoing percutaneous coronary intervention.

Original languageEnglish
Pages (from-to)240-261
Number of pages22
Issue number3
StatePublished - 16 Jul 2019


  • clinical trial protocols as topic
  • hemorrhage
  • percutaneous coronary intervention


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