🩸 ARC-HBR High Bleeding Risk Criteria
UseWhen to use: before/at PCI when choosing stent strategy and DAPT duration.
StrataBinary HBR definition (~≥4% 1-year BARC 3/5 or ≥1% ICH). More criteria → higher risk.
LimitsWhen not to use: to withhold indicated PCI for ACS. · Pitfall: scoring both major and minor CKD/anemia bands for the same p… · Pair with ischemic risk (e.g. PRECISE-DAPT context).
SourceUrban P, et al. Circulation 2019 (ARC-HBR)
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
≥1 major or ≥2 minor.
When to use
When to use: before/at PCI when choosing stent strategy and DAPT duration.
How it works
HBR if ≥1 major OR ≥2 minor consensus criteria (Urban 2019 table).
Key points
- ≥1 major or ≥2 minor.
- Consensus criteria.
- Next: PRECISE-DAPT / DAPT score / HAS-BLED.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Major: anticipated long-term oral anticoagulation | No (0) |
|---|---|
| Major: severe/end-stage CKD (eGFR < 30) | No (0) |
| Major: hemoglobin < 11 g/dL | No (0) |
| Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) | No (0) |
| Major: platelets < 100×10⁹/L | No (0) |
| Major: chronic bleeding diathesis | No (0) |
| Major: cirrhosis with portal hypertension | No (0) |
| Major: active malignancy (excl. nonmelanoma skin) within 12 mo | No (0) |
| Major: prior spontaneous ICH (any time); traumatic ICH <12 mo; bAVM; or mod/severe ischemic stroke <6 mo | No (0) |
| Major: nondeferrable major surgery on DAPT | No (0) |
| Major: major surgery or major trauma within 30 d before PCI | No (0) |
| Minor: age ≥ 75 y | No (0) |
| Minor: moderate CKD (eGFR 30–59) | No (0) |
| Minor: Hb 11–12.9 (men) or 11–11.9 (women) g/dL | No (0) |
| Minor: spontaneous bleed needing hosp/transfusion in past 12 mo (not meeting major) | No (0) |
| Minor: long-term oral NSAIDs or steroids | No (0) |
| Minor: any prior ischemic stroke not meeting major criterion | No (0) |
→ARC-HBRNot HBR
- Major criteria：0
- Minor criteria：0
- Rule：≥1 major OR ≥2 minor = HBR
| Major: anticipated long-term oral anticoagulation | Yes — major |
|---|---|
| Major: severe/end-stage CKD (eGFR < 30) | Yes — major |
| Major: hemoglobin < 11 g/dL | Yes — major |
| Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) | Yes — major |
| Major: platelets < 100×10⁹/L | Yes — major |
| Major: chronic bleeding diathesis | Yes — major |
| Major: cirrhosis with portal hypertension | Yes — major |
| Major: active malignancy (excl. nonmelanoma skin) within 12 mo | Yes — major |
| Major: prior spontaneous ICH (any time); traumatic ICH <12 mo; bAVM; or mod/severe ischemic stroke <6 mo | Yes — major |
| Major: nondeferrable major surgery on DAPT | Yes — major |
| Major: major surgery or major trauma within 30 d before PCI | Yes — major |
| Minor: age ≥ 75 y | Yes — minor |
| Minor: moderate CKD (eGFR 30–59) | Yes — minor |
| Minor: Hb 11–12.9 (men) or 11–11.9 (women) g/dL | Yes — minor |
| Minor: spontaneous bleed needing hosp/transfusion in past 12 mo (not meeting major) | Yes — minor |
| Minor: long-term oral NSAIDs or steroids | Yes — minor |
| Minor: any prior ischemic stroke not meeting major criterion | Yes — minor |
→ARC-HBRHBR positive
- Major criteria：11
- Minor criteria：6
- Rule：≥1 major OR ≥2 minor = HBR
Verification & sources · governance
FAQ
Frequently asked questions
- Does ARC-HBR High Bleeding Risk Criteria upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is ARC-HBR High Bleeding Risk Criteria calculated in practice? Can you show a worked example?
- Inputs: Major: anticipated long-term oral anticoagulation No (0), Major: severe/end-stage CKD (eGFR < 30) No (0), Major: hemoglobin < 11 g/dL No (0), Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) No (0), Major: platelets < 100×10⁹/L No (0), Major: chronic bleeding diathesis No (0), Major: cirrhosis with portal hypertension No (0), Major: active malignancy (excl. nonmelanoma skin) within 12 mo No (0)… → Result: ARC-HBR Not HBR（Major criteria: 0, Minor criteria: 0, Rule: ≥1 major OR ≥2 minor = HBR） Inputs: Major: anticipated long-term oral anticoagulation Yes — major, Major: severe/end-stage CKD (eGFR < 30) Yes — major, Major: hemoglobin < 11 g/dL Yes — major, Major: spontaneous bleed needing hosp/transfusion in past 6 mo (or any time if recurrent) Yes — major, Major: platelets < 100×10⁹/L Yes — major, Major: chronic bleeding diathesis Yes — major, Major: cirrhosis with portal hypertension Yes — major, Major: active malignancy (excl. nonmelanoma skin) within 12 mo Yes — major… → Result: ARC-HBR HBR positive（Major criteria: 11, Minor criteria: 6, Rule: ≥1 major OR ≥2 minor = HBR）