TY - JOUR T1 - CRUSADE: Is it still a good score to predict bleeding in acute coronary syndrome? JO - Revista Portuguesa de Cardiologia (English edition) T2 - AU - Bento,Dina AU - Marques,Nuno AU - Azevedo,Pedro AU - Guedes,João AU - Bispo,João AU - Silva,Daniela AU - Amado,José AU - Santos,Walter AU - Mimoso,Jorge AU - de Jesus,Ilídio SN - 21742049 M3 - 10.1016/j.repce.2018.02.020 DO - 10.1016/j.repce.2018.02.020 UR - https://www.revportcardiol.org/en-crusade-is-it-still-good-articulo-S2174204918303805 AB - IntroductionMajor bleeding is a serious complication of acute coronary syndrome (ACS) and is associated with a worse prognosis. The CRUSADE bleeding score is used to stratify the risk of major bleeding in ACS. ObjectiveTo assess the predictive ability of the CRUSADE score in a contemporary ACS population. MethodsIn a single-center retrospective study of 2818 patients admitted with ACS, the CRUSADE score was calculated for each patient and its discrimination and goodness of fit were assessed by the area under the receiver operating characteristic curve (AUC) and by the Hosmer-Lemeshow test, respectively. Predictors of in-hospital major bleeding (IHMB) were determined. ResultsThe IHMB rate was 1.8%, significantly lower than predicted by the CRUSADE score (7.1%, p<0.001). The incidence of IHMB was 0.5% in the very low risk category (rate predicted by the score 3.1%), 1.5% in the low risk category (5.5%), 1.6% in the moderate risk category (8.6%), 5.5% in the high risk category (11.9%), and 4.4% in the very high risk category (19.5%). The predictive ability of the CRUSADE score for IHMB was only moderate (AUC 0.73).The in-hospital mortality rate was 4.0%. Advanced age (p=0.027), femoral vascular access (p=0.004), higher heart rate (p=0.047) and ticagrelor use (p=0.027) were independent predictors of IHMB. ConclusionsThe CRUSADE score, although presenting some discriminatory power, significantly overestimated the IHMB rate, especially in patients at higher risk. These results question whether the CRUSADE score should continue to be used in the stratification of ACS. ER -