In-hospital prognosis of high bleeding risk patients with
an acute coronary syndrome and successful percutaneous
coronary intervention: a single-center real-world registry

Charalampos Kakderis; Matthaios Didagelos; Thomas Zegkos; Konstantinos Theodoropoulos; Antonios Kouparanis; Dimitra Ioakeimidou; Anna Iliou; George Kassimis; Stergios Tzikas; Antonios Ziakas

doi:10.5114/aic.2025.156886

Abstract

4/2025 vol. 21

Original paper

In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry

Charalampos Kakderis ¹

,

Matthaios Didagelos ¹

,

Thomas Zegkos ¹

,

Konstantinos C. Theodoropoulos ¹

,

Antonios Kouparanis ¹

,

Dimitra Ioakeimidou ¹

,

Anna Iliou ¹

,

George Kassimis ²

,

Stergios Tzikas ³

,

Antonios Ziakas ¹

First Cardiology Department, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
Second Cardiology Department, Hippokration University Hospital, Aristotle University of Thessaloniki, Greece
Third Cardiology Department, Hippokration University Hospital, Aristotle University of Thessaloniki, Greece

Adv Interv Cardiol 2025; 21, 4 (82): 512–520

DOI: https://doi.org/10.5114/aic.2025.156886

Online publish date: 2025/12/10

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AMA

Kakderis C, Didagelos M, Zegkos T, et al. In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2025;21(4):512-520. doi:10.5114/aic.2025.156886.

APA

Kakderis, C., Didagelos, M., Zegkos, T., Theodoropoulos, K. C., Kouparanis, A., & Ioakeimidou, D. et al. (2025). In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 21(4), 512-520. https://doi.org/10.5114/aic.2025.156886

Chicago

Kakderis, Charalampos, Matthaios Didagelos, Thomas Zegkos, Konstantinos C Theodoropoulos, Antonios Kouparanis, Dimitra Ioakeimidou, and Anna Iliou et al. 2025. "In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 21 (4): 512-520. doi:10.5114/aic.2025.156886.

Harvard

Kakderis, C., Didagelos, M., Zegkos, T., Theodoropoulos, K., Kouparanis, A., Ioakeimidou, D., Iliou, A., Kassimis, G., Tzikas, S., and Ziakas, A. (2025). In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 21(4), pp.512-520. https://doi.org/10.5114/aic.2025.156886

MLA

Kakderis, Charalampos et al. "In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 21, no. 4, 2025, pp. 512-520. doi:10.5114/aic.2025.156886.

Vancouver

Kakderis C, Didagelos M, Zegkos T, Theodoropoulos K, Kouparanis A, Ioakeimidou D et al. In-hospital prognosis of high bleeding risk patients with an acute coronary syndrome and successful percutaneous coronary intervention: a single-center real-world registry. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2025;21(4):512-520. doi:10.5114/aic.2025.156886.

Introduction

The management of high bleeding risk (HBR) patients with an acute coronary syndrome (ACS) who undergo percutaneous coronary intervention (PCI) is challenging because these patients combine a severe thrombotic burden with a significant risk of bleeding complications.

Aim

The aim of this study was to quantify the prevalence of HBR patients in a real-world ACS population, identify their in-hospital prognosis, and record their bleeding complications compared to non-HBR patients.

Material and methods

In this real-world registry, patients with an ACS who had undergone successful revascularization with PCI were classified into HBR and non-HBR based on the Academic Research Consortium for High Bleeding Risk (ARC-HBR) criteria and were monitored during their hospitalization.

Results

A total of 314 patients were enrolled: 103 HBR (32.8%) and 211 (67.2%) non-HBR. In-hospital all-cause mortality (17.4% vs. 2.84%, p < 0.001), cardiovascular mortality (12.6% vs. 2.84%, p < 0.001) and major bleeding events (15.5% vs. 1.89%, p < 0.001) were significantly higher in the HBR group. The trans-femoral access during PCI (OR = 3.524, 95% CI: 1.035–11.991, p = 0.044) and the baseline estimated glomerular filtration rate (eGFR) (OR = 0.966, 95% CI: 0.938–0.996, p = 0.027) were the only independent predictors of severe bleeding. More specifically, an e-GFR value ≤ 50 ml/min was calculated to predict in-hospital major bleeding complications in HBR patients with 87.5% sensitivity and 64.37% specificity.

Conclusions

In-hospital all-cause mortality, cardiovascular mortality, and major bleeding events were significantly higher in HBR patients with an ACS compared to non-HBR patients. HBR patients with baseline impaired renal function should be carefully monitored for severe bleeding complications.

Keywords

percutaneous coronary intervention, bleeding, high bleeding risk, acute coronary syndrome

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