Major and minor criteria for high bleeding risk at the time of percutaneous coronary intervention

Major	Minor
	Age ≥75 years
Anticipated use of long-term oral anticoagulation*
Severe or end-stage CKD (eGFR <30 mL/min)	Moderate CKD (eGFR 30 to 59 mL/min)
Hemoglobin <11 g/dL	Hemoglobin 11 to 12.9 g/dL for men and 11 to 11.9 g/dL for women
Spontaneous bleeding requiring hospitalization or transfusion in the past 6 months or at any time, if recurrent	Spontaneous bleeding requiring hospitalization or transfusion within the past 12 months not meeting the major criterion
Moderate or severe baseline thrombocytopenia^¶ (platelet count <100×10⁹/L)
Chronic bleeding diathesis
Liver cirrhosis with portal hypertension
	Long-term use of oral NSAIDs or steroids
Active malignancy^Δ (excluding nonmelanoma skin cancer) within the past 12 months
Previous spontaneous ICH (at any time) Previous traumatic ICH within the past 12 months Presence of a bAVM Moderate or severe ischemic stroke^◊ within the past 6 months	Any ischemic stroke at any time not meeting the major criterion
Nondeferrable major surgery on DAPT
Recent major surgery or major trauma within 30 days before PCI

CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; NSAID: nonsteroidal anti-inflammatory drug; ICH: intracranial hemorrhage; bAVM: brain arteriovenous malformation; DAPT: dual antiplatelet therapy; PCI: percutaneous coronary intervention.
* This excludes vascular protection doses.^[1]
¶ Baseline thrombocytopenia is defined as thrombocytopenia before PCI.
Δ Active malignancy is defined as diagnosis within 12 months and/or ongoing requirement for treatment (including surgery, chemotherapy, or radiotherapy).
◊ National Institutes of Health Stroke Scale score ≥5.

Reference:

Eikelboom JW, Connolly SJ, Bosch J, et al. Rivaroxaban with or without aspirin in stable cardiovascular disease. N Engl J Med 2017; 377:1319.

From: Urban P, Mehran R, Colleran R, et al. Defining high bleeding risk in patients undergoing percutaneous coronary intervention. Circulation 2019; 140:240. DOI: 10.1161/CIRCULATIONAHA.119.040167. Copyright © 2019 American Heart Association. Reproduced with permission from Wolters Kluwer Health. Unauthorized reproduction of this material is prohibited.

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Major and minor criteria for high bleeding risk at the time of percutaneous coronary intervention