🩸 ARC-HBR (haut risque hémorragique)
UsageQuand utiliser : before/at PCI when choosing stent strategy and DAPT duration.
StratificationBinary HBR definition (~≥4% 1-year BARC 3/5 or ≥1% ICH). More criteria → higher risk.
LimitesQuand ne pas utiliser : to withhold indicated PCI for ACS. · Piège : scoring both major and minor CKD/anemia bands for the same pa… · Pair with ischemic risk (e.g. PRECISE-DAPT context).
SourceUrban P, et al. Circulation 2019 (ARC-HBR)
Prochaines étapes de garde
Après le score : scène, scores proches et parcours. Référence locale — pas d’écriture HIS.
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Méthodologie · exemple, recommandations et notes
≥1 major or ≥2 minor.
Quand l'utiliser
Quand utiliser : before/at PCI when choosing stent strategy and DAPT duration.
Comment ça marche
HBR if ≥1 major OR ≥2 minor consensus criteria (Urban 2019 table).
Points clés
- ≥1 major or ≥2 minor.
- Consensus criteria.
- Suite : PRECISE-DAPT / DAPT score / HAS-BLED.
Références
Note sur l'outil
Réservé aux professionnels de santé ; ne remplace pas le jugement clinique.
Exemple de calcul
Les valeurs ci-dessous proviennent des exemples définis dans l'outil et sont calculées côté serveur avec la formule de cette page, afin de vérifier rapidement l'opération. Ceci illustre uniquement la substitution des valeurs : ce n'est ni un avis clinique ni un cas réel.
| 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
Vérification et sources · gouvernance
FAQ
Questions fréquentes
- ARC-HBR (haut risque hémorragique) envoie-t-il des données patient ? Où le calcul est-il fait ?
- Le calcul s'effectue localement dans le navigateur ; aucune donnée n'est envoyée. Destiné aux professionnels de santé ; interpréter avec l'histoire, les examens et les protocoles locaux — ni diagnostic ni prescription.
- Comment calcule-t-on ARC-HBR (haut risque hémorragique) en pratique ? Pouvez-vous montrer un exemple résolu ?
- Données: 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)… → Résultat: ARC-HBR Not HBR（Major criteria: 0, Minor criteria: 0, Rule: ≥1 major OR ≥2 minor = HBR） Données: 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… → Résultat: ARC-HBR HBR positive（Major criteria: 11, Minor criteria: 6, Rule: ≥1 major OR ≥2 minor = HBR）