Prognostic Value of Short-Term Mortality Using BARC Bleeding Classification in Acute Myocardial Infarction Patients

Abstract

Introduction: Acute myocardial infarction (AMI) treatment involves dual antiplatelet and anticoagulant therapy, which reduces thrombotic risks but increases bleeding risk. The Bleeding Academic Research Consortium (BARC) classification has emerged as a valuable tool for assessing bleeding severity. This study aims to evaluate the short-term mortality predictive value of BARC classification among AMI patients at 115 People's Hospital in Vietnam. Methods: This was a prospective cohort study conducted from May to August 2023 involving 289 AMI patients. Data collection included clinical and demographic characteristics, laboratory results, procedural details, and post-treatment outcomes. Bleeding events were categorized using the BARC classification. Statistical analyses determined bleeding incidence, associated risk factors, and short-term mortality predictive value. Results: Of the 289 patients, 28.4% experienced bleeding, and 7.6% had major bleeding (BARC 3-5). The mean age was 64.61 years, with 62.98% being male. The main bleeding sites included procedural access points (28%) and gastrointestinal locations (23%). Factors associated with major bleeding included elevated BMI, chronic kidney disease, and higher creatinine levels. The BARC classification showed moderate predictive ability for 30-day mortality (AUC = 0.647, p = 0.002). BARC 3A had high specificity (97.5%) but lower sensitivity (34.8%). Conclusion: The BARC classification is a valuable predictor of short-term mortality among AMI patients. Enhanced utilization of this tool may aid clinicians in balancing anticoagulant therapy risks, improving patient outcomes. Further studies are recommended to refine bleeding risk assessments and broaden applicability in varied clinical settings.