P205 - ASSESSMENT OF BLEEDING RISK AMONG PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION WITH DRUG-ELUTING STENTS FOR ACUTE CORONARY SYNDROME AT CHUS IN 2023

Background: Recent updates to Canadian cardiovascular guidelines have endorsed a shortened duration of dual antiplatelet therapy (DAPT) in patients at high bleeding risk (HBR) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for acute coronary syndromes (ACS). The Academic Research Consortium for High Bleeding Risk (ARC-HBR) has proposed standardized criteria to identify such patients, yet no Canadian data currently exist regarding the prevalence or characteristics of HBR patients within this context. This study aimed to assess the proportion of HBR patients treated with DES for ACS at Sherbrooke University Hospital Center (CHUS) in 2023, compare prevalence based on referring physician specialty, and identify the most common ARC-HBR criteria in this population.

METHODS AND RESULTS: We conducted a retrospective cohort study including patients aged ≥18 who underwent DES PCI for ACS at CHUS in 2023. Patients were classified as HBR if they met ≥1 major or ≥2 minor ARC-HBR criteria. Demographics, clinical characteristics, referring physician specialty, and laboratory values were collected. Statistical analyses included chi-square and independent t-tests with a significance threshold of 0.05. Among 738 patients, 237 (32.1%) met ARC-HBR criteria. No significant difference was found in HBR prevalence between referrals from cardiology and internal medicine (p = 0.35). HBR patients were significantly older (mean 76.2 vs. 65.0 years, p < 0.01), more likely to be female (34.6% vs. 26.5%, p = 0.02), and had a higher prevalence of complex coronary anatomy (32.1% vs. 22.0%, p < 0.01) and NSTEMI presentations (47.3% vs. 33.5%, p < 0.01). Common major criteria included long-term anticoagulation (36.3%) and hemoglobin < 110 g/L (16.9%). Frequent minor criteria were age ≥75 years (68.4%) and moderate renal impairment (48.1%).

Conclusion: Nearly one-third of ACS patients treated with DES PCI at CHUS in 2023 were at high bleeding risk per ARC-HBR criteria. These findings support the relevance of HBR identification in routine clinical practice and highlight the potential for implementing shorter DAPT strategies in this population.