Prognosis of Patients with Acute Coronary Syndromes and Bleeding—The Importance of Routine Use of a Bleeding Risk Score

Introduction: Recent studies showed relation between mortality and bleeding in acute coronary syndromes. Objective: The objective is to analyze the prognosis of patients with acute coronary syndromes with or without in-hospital major and/or minor bleedings. Methods: This was a prospective data bank analysis study with 546 patients (39 with bleeding (group I) and 507 without bleeding (group II)) with acute coronary syndromes included between May 2010 and May 2013. Besides, Mehran bleeding risk score was calculated to all patients. The primary endpoint was all causes of in-hospital death and combined events. Comparison between groups was made by Anova and Q-square. Multivariate analysis was determined by logistic regression and was considered significant when p < 0.05. Long-term mortality and combined events were studied using Kaplan-meyer curves. Results: The median Mehran bleeding risk score was 18.78 and 15.11 in groups I and II, respectively. Major bleeding was observed in 4.4%. Significant difference was observed between groups I and II in deaths (20.5% vs 2.6%, p = 0.005) and combined events (35.9% vs 11.4%, p < 0.001). The same results were observed in multivariate and long-term analysis. Conclusions: Almost half of patients with acute coronary syndromes had higher risk of bleeding, and that with major or minor bleedings had greater deaths and combined events.