The High Bleeding Risk Patient with Coronary Artery Disease

Cardiol Clin. 2020 Nov;38(4):481-490. doi: 10.1016/j.ccl.2020.06.002. Epub 2020 Sep 17.


Out-of-hospital bleeding is a common complication after percutaneous coronary intervention (PCI) due to the concomitant need for dual antiplatelet therapy. A significant proportion of patients undergoing PCI carry specific clinical characteristics posing them at high bleeding risk (HBR), increasing the risk of hemorrhagic complications secondary to antithrombotic therapy. Identifying patients at HBR and adjust antithrombotic therapy accordingly to optimize treatment benefits and risk is a challenge of modern cardiology. Recently, multiple definitions and tools have been provided to help clinicians with prognostic stratification and treatment decision making in this subgroup.

Keywords: Bleeding; Coronary; DAPT; PCI; PRECISE-DAPT; Risk; Score; Stent.

Publication types

  • Review

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Coronary Artery Disease / complications*
  • Coronary Artery Disease / surgery
  • Drug Therapy, Combination
  • Hemorrhage / chemically induced*
  • Humans
  • Percutaneous Coronary Intervention / adverse effects*
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Prognosis
  • Risk Assessment
  • Risk Factors


  • Anticoagulants
  • Platelet Aggregation Inhibitors