Prediction of risk of major bleeding with using CRUSADE bleeding score in Acute coronary syndrome patients: A case series

Abstract

Use of intravenous heparin in Acute coronary syndrome possess a major risk of bleeding to patients. However, the estimation of risk using bleeding scores in Indian settings is yet to be established. These case series assess the risk of major bleeding associated with the use of Antithrombotic agents in patients with acute coronary syndrome using CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) bleeding score. Relevant patient data was collected from hospital records and patients were followed up till discharge. All the four cases reported showed the risk of in-hospital bleeding with anti-thrombotic agents evident as two cases of hematuria, one case of gum bleeding and one case of hemorrhagic stools. All the patient presented with chest pain to the hospital; following a diagnosis of the acute coronary syndrome, they were prescribed with antiplatelets and anticoagulants. This accompanied a bleeding event which was categorized using CRUSADE bleeding risk score. In-hospital major bleeding imposes a burden on the patient's quality of life. Use of CRUSADE bleeding score helps to predict the severity of risk in a less expensive, non-invasive manner. Further, large scale studies will pave the way for using CRUSADE as an efficient bleeding predictor score.