PURPOSE: To evaluate the outcome of patients with an established indication for 
oral anticoagulation (OAC) undergoing coronary stent implantation (PCI-S) and 
stratified by the baseline risk of bleeding.
MATERIAL AND METHODS: The database of the prospective, multicentre, 
observational WAR-STENT registry (ClinicalTrials.gov identifier NCT00722319) was 
analyzed and patients with atrial fibrillation and CHA2DS2-VASc score ≥2, 
mechanical heart valve, prior cardiac embolism, intra-cardiac thrombus and 
recent venous thromboembolism who were treated with either triple (warfarin, 
aspirin and clopidogrel) or dual (warfarin and clopidogrel) or dual antiplatelet 
(aspirin and clopidogrel) therapy, identified. Patients were then sorted into 
two groups at non-low and low risk of bleeding, as defined by an ATRIA score >3 
and ≤3 respectively, and compared regarding major adverse cardiac and vascular 
events (MACVE) and bleeding.
RESULTS: At 12-month follow up, MACVE were comparable in the two groups, whereas 
total, major and minor bleeding, as well as combined MACVE and total bleeding, 
were significantly more frequent in the non-low bleeding risk group. Upon Cox 
univariate and multivariable analysis, non-low bleeding risk category confirmed 
as an independent predictor of major bleeding. The choice of antithrombotic 
therapy however, appeared not to be influenced by the bleeding risk category at 
baseline.
CONCLUSIONS: In patients with an established indication for OAC undergoing 
PCI-S, non-low bleeding risk category is the most potent independent predictor 
of major bleeding. Stratification of the bleeding risk at baseline should 
therefore be regarded as an indispensable process to be carried out before 
selection of the antithrombotic therapy.