ARC-HBR Criteria

Oral anticoagulation use Anticipated long-term OAC use (VKA or DOAC)

Major

Severe/end-stage CKD eGFR < 30 mL/min/1.73m²

Major

Moderate–severe anemia Hemoglobin < 11 g/dL

Major

Severe thrombocytopenia Platelet count < 100 × 10⁹/L

Major

Chronic bleeding diathesis Hemophilia, von Willebrand disease, or other coagulopathy

Major

Cirrhosis with portal hypertension

Major

Active malignancy Excluding non-melanoma skin cancer, within 12 months

Major

Previous spontaneous ICH (any time) Intracerebral hemorrhage

Major

Recent traumatic brain injury or ischemic stroke Within 6 months; cannot tolerate interruption of P2Y12i for ≥ 5 days

Major

Brain AVM or aneurysm Presence of intracranial vascular malformation

Major

Recent major non-ICH bleeding Within 6 months or recurrent event

Major

Non-deferrable major surgery on DAPT Surgery planned within 30 days that cannot be delayed

Major

Age ≥ 75 years

Minor

Moderate CKD eGFR 30–59 mL/min/1.73m²

Minor

Mild anemia Hemoglobin 11–12.9 g/dL (men) or 11–11.9 g/dL (women)

Minor

Chronic NSAID or steroid use Long-term use anticipated

Minor

Prior bleeding requiring hospitalization/transfusion Any time in the past (not meeting major criteria timing)

Minor

Prior ischemic stroke (not recent) Previous ischemic stroke > 6 months ago

Minor