{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:35:00Z","timestamp":1777408500328,"version":"3.51.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T00:00:00Z","timestamp":1733011200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009420","name":"Hospital District of Southwest Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009420","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Turunmaa Duodecim Society"},{"DOI":"10.13039\/100007634","name":"Ida Montin Foundation","doi-asserted-by":"publisher","award":["20230116"],"award-info":[{"award-number":["20230116"]}],"id":[{"id":"10.13039\/100007634","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Turku Joint Research Grant Fund","award":["202392826"],"award-info":[{"award-number":["202392826"]}]},{"name":"Paavo Ilmari Ahvenainen Foundation"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and aims<\/jats:title>\n                  <jats:p>The Academic Research Consortium for High Bleeding Risk criteria (ARC-HBR) are recommended by guidelines for bleeding risk assessment in ST-elevation myocardial infarction (STEMI). The aim of this study was to identify possible other risk factors and adjust the original ARC-HBR criteria for confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>All consecutive STEMI patients managed in a Finnish tertiary hospital between 2016 and 2022 were identified using a database search. Data collection was done by reviewing electronic patient records. Bleeding risk was assessed according to the ARC-HBR criteria. The primary endpoint was non-access site bleeding academic research consortium (BARC) type 3 or 5 bleeding during 1-year follow-up. A total of 1548 STEMI patients were analysed. HBR criteria was fulfilled in 661 (42.7%). Multivariable competing risk analysis identified only 4 individual ARC-HBR criteria as independent risk factors for bleeding. Smoking status was identified as a novel bleeding risk factor. Current and former smokers had increased bleeding risk compared with never smokers [hazard ratio (HR) 3.01, 95% confidence interval (CI) 1.62\u20135.61 and HR 1.99, CI 1.19\u20133.34]. In those not meeting any ARC-HBR criteria, cumulative BARC 3 or 5 incidence of current smoking was 3.40% and intracranial haemorrhage (ICH) 1.36%. Thus, exceeding ARC-HBR definition for a major criterion. In the non-HBR group the prevalence of current smoking was 40.4% (n\u00a0=\u00a0358).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Current and former smoking predicts major bleeding complications after STEMI. Current smoking is highly prevalent among those classified as non-HBR according to the ARC-HBR criteria.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjqcco\/qcae104","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T15:25:04Z","timestamp":1732893904000},"page":"756-765","source":"Crossref","is-referenced-by-count":4,"title":["Performance of the ARC-HBR criteria in ST-elevation myocardial infarction. Significance of smoking as an additional bleeding risk factor"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1207-2362","authenticated-orcid":false,"given":"Henri","family":"Kesti","sequence":"first","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]},{"name":"Faculty of Medicine, University of Turku , Kiinamyllynkatu 10, 20520 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalle","family":"Mattila","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Turku , Kiinamyllynkatu 10, 20520 Turku ,","place":["Finland"]},{"name":"Emergency Department, Turku University Hospital , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuli","family":"Jaakkola","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6420-8607","authenticated-orcid":false,"given":"Joonas","family":"Lehto","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nea","family":"S\u00f6derblom","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]},{"name":"Faculty of Medicine, University of Turku , Kiinamyllynkatu 10, 20520 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalle","family":"Kalliovalkama","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]},{"name":"Faculty of Medicine, University of Turku , Kiinamyllynkatu 10, 20520 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pekka","family":"Porela","sequence":"additional","affiliation":[{"name":"Heart Centre, Turku University Hospital and University of Turku , H\u00e4meentie 11, PO Box 52, 20521 Turku ,","place":["Finland"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,11,30]]},"reference":[{"key":"2025091815440928900_bib1","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1093\/eurheartj\/ehw525","article-title":"Trade-off of myocardial infarction vs. bleeding types on 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