🩸 ARC-HBR (alto riesgo de sangrado)
UsoCuándo usar: before/at PCI when choosing stent strategy and DAPT duration.
EstratificaciónBinary HBR definition (~≥4% 1-year BARC 3/5 or ≥1% ICH). More criteria → higher risk.
LímitesCuándo no usar: to withhold indicated PCI for ACS. · Error frecuente: scoring both major and minor CKD/anemia bands for th… · Pair with ischemic risk (e.g. PRECISE-DAPT context).
FuenteUrban P, et al. Circulation 2019 (ARC-HBR)
Siguientes pasos del turno
Tras puntuar: escena, escalas afines y vía. Solo referencia local — sin escritura HIS.
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Metodología · ejemplo, guías y notas completas
≥1 major or ≥2 minor.
Cuándo usarla
Cuándo usar: before/at PCI when choosing stent strategy and DAPT duration.
Cómo funciona
HBR if ≥1 major OR ≥2 minor consensus criteria (Urban 2019 table).
Puntos clave
- ≥1 major or ≥2 minor.
- Consensus criteria.
- Siguiente: PRECISE-DAPT / DAPT score / HAS-BLED.
Referencias
Nota de la herramienta
Para profesionales sanitarios; no sustituye el juicio clínico.
Cálculo de ejemplo
Los valores siguientes proceden de los ejemplos definidos en la propia herramienta y se calculan en el servidor con la fórmula de esta página, para poder verificar la operación rápidamente. Solo ilustra cómo sustituir los valores: no es consejo clínico ni un caso real.
| 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
Verificación y fuentes · gobernanza
Preguntas frecuentes
Preguntas frecuentes
- ¿ARC-HBR (alto riesgo de sangrado) sube datos del paciente? ¿Dónde se calcula?
- El cálculo se realiza localmente en el navegador; no se suben datos. Solo para profesionales sanitarios; interprete con historia, pruebas y protocolos locales — no es diagnóstico ni prescripción.
- ¿Cómo se calcula ARC-HBR (alto riesgo de sangrado) en la práctica? ¿Puede mostrar un ejemplo resuelto?
- Datos: 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)… → Resultado: ARC-HBR Not HBR（Major criteria: 0, Minor criteria: 0, Rule: ≥1 major OR ≥2 minor = HBR） Datos: 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… → Resultado: ARC-HBR HBR positive（Major criteria: 11, Minor criteria: 6, Rule: ≥1 major OR ≥2 minor = HBR）