Haemoglobin drop with and without bleeding in patients with acute coronary syndromes 1 | INTRODUCTION-THE
IMPACT OF BLEEDING EVENTS ON OUTCOMEEarly invasive intervention in high-risk patients and widespread utilization of dedicated and evidence-based antithrombotic treatment result in improved patient outcomes of patients with acute coronary syndromes (ACS). 1,2 However, these management strategies result in a higher risk of bleeding events. The occurrence of bleeding complications is independently associated with an increased risk of unfavourable outcomes including recurrent myocardial infarction (MI), stroke and death. [3][4][5][6] Several studies comparing antithrombotic agents suggest that a decrease in bleeding events is associated with lower mortality. 7 Thus, assessment of bleeding risk and preventive measures to avoid bleeding complications have become highly relevant in current clinical practice. 1,8 Factors associated with an increased risk of periprocedural bleeding include patient characteristics, procedural issues and the antithrombotic treatment regimen. Characteristics of patients at high risk of bleeding complications include advanced age, female sex, low body weight, impaired renal function, diabetes, arterial hypertension, haematologic abnormalities, anaemia, history of bleeding, anticipated use of long-term oral anticoagulation, advanced liver disease and a history of stroke or atherosclerotic vascular disease. 9