Bleeding events result in morbidity and mortality in patients who underwent
percutaneous coronary intervention (PCI). There are limited data on the predicting
bleeding complications in patients who underwent
stent implantation and subsequent dual antiplatelet
therapy (PRECISE-
DAPT) and Academic Research Consortium for High
Bleeding Risk (
ARC-HBR) scores' ability to predict in-hospital outcomes in patients who underwent PCI. Consecutive patients who underwent PCI at tertiary centers from January 2016 to March 2018 were identified and the
bleeding risk scores were calculated. The primary end point was the National Cardiovascular Data Registry-defined in-hospital
bleeding stratified by low versus high predicted
bleeding risk. The major and net adverse cardiovascular events were also examined. The discriminatory ability of the risk models was determined using receiver operating characteristic curves. Among 3,659 patients studied, the in-hospital major
bleeding was 3.3% (n = 121). The patients characterized as high
bleeding risk by either criterion had significantly higher
bleeding rates than those meeting the low-risk criteria (
ARC-HBR 5.4% vs 3.3%, p <0.001; PRECISE-
DAPT 5.8% vs 2.4%, p <0.001), and higher major adverse cardiovascular events and net adverse clinical events. These risk estimates showed moderate and similar predictive ability (
ARC-HBR high-risk area under the receiver operating characteristic curve [AUC] 0.62, PRECISE-
DAPT ≥25 AUC 0.61, p = 0.49), with no incremental benefit to adding the estimates (AUC 0.60). The subgroup analysis revealed that women had higher
bleeding rates than men (5.53% vs 2.39%, p <0.001); however, the predictive ability of the criteria were similar in women and men. The patients identified as having a high
bleeding risk by the PRECISE-
DAPT and the
ARC-HBR criteria before PCI are at high risk for in-hospital
bleeding and adverse outcomes independent of gender. The 2 scores have moderate predictive ability for bleeds. Further study is needed to determine strategies to reduce risk in this population.