P6450Haemorrhagic risk in patients presenting with acute coronary syndrome and renal dysfunction: which score is a better predictor of bleeding risk on a daily-basis?

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Introduction: Acute Coronary Syndromes are often complicated by potentially fatal haemorrhagic events. Patients with concomitant renal dysfunction are a particularly susceptible group to this type of complication and are frequently underrepresented in the literature, as different evidence gaps remain to be explored. Methods: Prospective registry of 545 consecutive patients admitted between October 2009 and September 2016 presenting with Acute Coronary Syndrome and renal dysfunction (CrCl ≤60 ml/min, Cockcroft-Gault equation). CRUSADE bleeding Score (Cs), ATRIA bleeding score (As) and ORBIT Score (Os) were then calculated for each patient. A comparison between the different scores regarding their prediction value, was then established using ROC (Receiver Operating Characteristics) curves and the deLong test. As a primary endpoint we defined the occurrence of a haemorrhagic event resulting in blood transfusion and then aimed to evaluate the scores performance on different subsets of patients: those presenting with ST-elevation myocardial infarction (STEMI) and those presenting with non-ST elevation myocardial infarction or Unstable Angina (NSTEMI/UA).

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