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Revista argentina de cardiología

versión On-line ISSN 1850-3748

Resumen

CHIRINO NAVARTA, DANIEL A. et al. Evaluation of the Orbit Bleeding Risk Score as Predictor of Major Bleeding in Patients with Acute Coronary Syndrome. Rev. argent. cardiol. [online]. 2022, vol.90, n.3, pp.175-180.  Epub 01-Jun-2022. ISSN 1850-3748.  http://dx.doi.org/10.7775/rac.es.v90.i3.20521.

Background:

Major bleeding is the most important complication of antithrombotic treatment in acute coronary syndrome (ACS) and is associated with higher mortality. Assessing the risk of bleeding is a challenge. The usefulness of the Orbit Bleeding Score (ORBIT) to assess the risk of bleeding in ACS has been scarcely studied.

Objective:

The aim of this study was to evaluate the ORBIT score as a predictor of major bleeding in patients hospitalized for ACS in whom anticoagulation is decided as part of the antithrombotic strategy.

Methods:

Patients admitted to two coronary care units with diagnosis of ACS who received anticoagulation as part of the antithrombotic therapy were retrospectively included in the study. The CRUSADE, ACTION-GWTG and ORBIT scores were calculated using the admission clinical data. The primary endpoint was major bleeding, defined as BARC 3 or 5 classification.

Results:

The study included 762 patients. Major bleeding occurred in 3.4% of cases. In the univariate analysis, the three scores were predictors of major bleeding, while in the multivariate analysis only the ORBIT score was an independent predictor of major bleeding (OR: 2.46, 95% CI 1.61-3.97, p <0.001). The area under the ROC curve was 0.70, 0.68 and 0.80 for the ACTION-GWTG, CRUSADE and ORBIT scores, respectively. The ORBIT score presented a higher area under the curve than the CRUSADE score (p=0.03) but without significant difference with the ACTION-GWTG score (p=0.06)

Conclusions:

The ORBIT score was the only independent predictor of major bleeding, presenting a better discrimination capacity than the CRUSADE score and a tendency to better capacity than the ACTION-GWTG score.

Palabras clave : Acute Coronary Syndrome; Risk Assessment; Hemorrhage.

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