{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:02:40Z","timestamp":1792098160576,"version":"4.4.0"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,12]]},"abstract":"\n Background<\/jats:title>\n \n Multiple scores have been proposed to stratify bleeding risk, but their value to guide dual antiplatelet therapy duration has never been appraised. We compared the performance of the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC\/AHA Guidelines), ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy), and HAS\u2010BLED (Hypertension, Abnormal Renal\/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs\/Alcohol Concomitantly) scores in 1946 patients recruited in the Prolonging Dual Antiplatelet Treatment After Grading Stent\u2010Induced Intimal Hyperplasia Study (\n PRODIGY<\/jats:styled-content>\n ) and assessed hemorrhagic and ischemic events in the 24\u2010 and 6\u2010month dual antiplatelet therapy groups.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Bleeding score performance was assessed with a Cox regression model and C statistics. Discriminative and reclassification power was assessed with net reclassification improvement and integrated discrimination improvement. The C statistic was similar between the\n CRUSADE<\/jats:styled-content>\n score (area under the curve 0.71) and\n ACUITY<\/jats:styled-content>\n (area under the curve 0.68), and higher than\n HAS<\/jats:styled-content>\n \u2212\n BLED<\/jats:styled-content>\n (area under the curve 0.63).\n CRUSADE<\/jats:styled-content>\n , but not\n ACUITY<\/jats:styled-content>\n , improved reclassification (net reclassification index 0.39,\n P<\/jats:italic>\n =0.005) and discrimination (integrated discrimination improvement index 0.0083,\n P<\/jats:italic>\n =0.021) of major bleeding compared with\n HAS<\/jats:styled-content>\n \u2010\n BLED<\/jats:styled-content>\n . Major bleeding and transfusions were higher in the 24\u2010 versus 6\u2010month dual antiplatelet therapy groups in patients with a CRUSADE score >40 (hazard ratio for bleeding 2.69,\n P<\/jats:italic>\n =0.035; hazard ratio for transfusions 4.65,\n P<\/jats:italic>\n =0.009) but not in those with CRUSADE score \u226440 (hazard ratio for bleeding 1.50,\n P<\/jats:italic>\n =0.25; hazard ratio for transfusions 1.37,\n P<\/jats:italic>\n =0.44), with positive interaction (\n P<\/jats:italic>\n int<\/jats:sub>\n =0.05 and\n P<\/jats:italic>\n int<\/jats:sub>\n =0.01, respectively). The number of patients with high\n CRUSADE<\/jats:styled-content>\n scores needed to treat for harm for major bleeding and transfusion were 17 and 15, respectively, with 24\u2010month rather than 6\u2010month dual antiplatelet therapy; corresponding figures in the overall population were 67 and 71, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Our analysis suggests that the\n CRUSADE<\/jats:styled-content>\n score predicts major bleeding similarly to ACUITY and better than HAS BLED in an all\u2010comer population with percutaneous coronary intervention and potentially identifies patients at higher risk of hemorrhagic complications when treated with a long\u2010term dual antiplatelet therapy regimen.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 00611286.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002524","type":"journal-article","created":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T01:32:34Z","timestamp":1537061554000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":59,"title":["Incremental Value of the CRUSADE, ACUITY, and HAS\u2010BLED Risk Scores for the Prediction of Hemorrhagic Events After Coronary Stent Implantation in Patients Undergoing Long or Short Duration of Dual Antiplatelet Therapy"],"prefix":"10.1161","volume":"4","author":[{"given":"Francesco","family":"Costa","sequence":"first","affiliation":[{"name":"Thoraxcenter Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Department of Clinical and Experimental Medicine, Policlinico \u201cG. Martino\u201d University of Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan G.","family":"Tijssen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Academic Medical Center University of Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Ariotti","sequence":"additional","affiliation":[{"name":"Thoraxcenter Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Giatti","sequence":"additional","affiliation":[{"name":"Cardiology Clinics Citta\u2019 di Rovigo Hospital Rovigo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Moscarella","sequence":"additional","affiliation":[{"name":"Division of Cardiology Department of Cardiothoracic Sciences Second University of Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Guastaroba","sequence":"additional","affiliation":[{"name":"Agenzia Sanitaria Regionale Regione Emilia Romagna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"De Palma","sequence":"additional","affiliation":[{"name":"Agenzia Sanitaria Regionale Regione Emilia Romagna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"And\u00f2","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Policlinico \u201cG. Martino\u201d University of Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Oreto","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine, Policlinico \u201cG. Martino\u201d University of Messina Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Zijlstra","sequence":"additional","affiliation":[{"name":"Thoraxcenter Erasmus Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Valgimigli","sequence":"additional","affiliation":[{"name":"Thoraxcenter Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Swiss Cardiovascular Center Bern Bern University Hospital Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu161"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.612812"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.07.957"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2005.06.056"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.071589"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409312"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31823a5596"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu278"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr236"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.828541"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.09.076"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.07.034"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.2929"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872612453924"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/2048872612469885"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.115.002524","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:00:38Z","timestamp":1715594438000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.115.002524"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,12]]},"references-count":16,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2015,12]]}},"alternative-id":["10.1161\/JAHA.115.002524"],"URL":"https:\/\/doi.org\/10.1161\/jaha.115.002524","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,12]]},"assertion":[{"value":"2015-08-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-12-07","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e002524"}}