Terms of Service
Click the Terms tab at the bottom of the app before using the CathPCI Bleeding Risk Calculator (“the Product”) to read the full Terms of Service and License Agreement (the “Agreement”) which governs the use of the Product. The Agreement includes, among other detailed terms and conditions, certain disclaimers of warranties by the American College of Cardiology Foundation (“ACCF”) and requires the user to agree to release ACCF from any and all liability arising in connection with your use of the Product. By using the Product, you accept and agree to be bound by all of the terms and conditions set forth in the Agreement, including such disclaimers and releases. If you do not accept the terms and conditions of the Agreement, you may not proceed to use the Product. The Agreement is subject to change from time to time, and your continued use of the Product constitutes your acceptance of and agreement to be bound by any revised terms of the Agreement.
For optimal use, the bleeding event risk estimate received should be used to inform the overall conversation about the risks/benefits of a CathPCI procedure. It should not be used to determine the need for or against this or any medical procedure.
See the “About” screen in this app for a definition of terms and additional instructions.
Bleeding Event is an absolute drop in hemoglobin ≥ , a RBC transfusion and/or a procedural intervention/surgery to reverse/stop bleeding that occurs within 72 hours of the PCI procedure.
The model provides an objective risk-adjusted estimate of bleeding which has real value for both patient and provider. It should be considered as one element in the evaluation process, to be considered along with the other traditional factors that determine whether the patient is an appropriate candidate for the procedure.
|Body Mass Index (BMI)||# kg/m2|
|Baseline Hemoglobin||g/dL g/L|
|Prior STEMI||Yes No|
|Prior Cardiogenic Shock||Yes No|
|Prior PCI||Yes No|
|Glomerular Filtration Rate (estimated)||N/A mL/min/1.73m2|
|Serum Creatinine (SCr)||mg/dL µmol/L|
COMMON PROBLEM: Improper Performance of Procedure
COMMON PROBLEM: Lack of Protocol to Prevent Postoperative Bleeding
COMMON PROBLEM: Lack of Knowledge About Patient Factors That Can Contribute to Risk of Postoperative Bleeding
COMMON PROBLEM: Failure to Identify Early Warning Signs of Postoperative Bleeding
COMMON PROBLEM: Improper Improper Preoperative, Intraoperative, and Postoperative Medication Management
COMMON PROBLEM: Lack of Communication Among Clinicians
COMMON PROBLEM: Failure to Communicate Early That Patient Is at Risk For Postoperative Bleeding Once Clinical Signs Are Recognized
|Demographic characteristics and medical history|
|Female vs. male||1.97||1.93–
|Dialysis vs. no disease||1.88||1.80–
|Moderate chronic kidney disease (GFR = 30–44 ml/min) vs. no disease||1.68||1.62–
|BMI (when BMI ≤ 30 kg/m2)∗||0.96||0.96–
|Mild chronic kidney disease (GFR = 45–59 ml/min) vs. no disease||1.34||1.31–
|Heart Failure NYHA class IV within 2 weeks Heart failure NYHA class IV within 2 weeks vs. no heart failure within 2 weeks||1.63||1.56–
|Age (≤70 yrs)∗||1.02||1.01–
|Chronic lung disease||1.23||1.19–
|Peripheral vascular disease||1.19||1.15–
|NYHA functional class IV HF within 2 weeks before PCI vs. NYHA functional class<IV||1.17||1.13–
|Age (>70 yrs)∗||1.01||1.00–
|Insulin requiring diabetes mellitus vs. no diabetes||1.09||1.06–
|Presenting characteristics and PCI status|
|Shock within 24 h before and at start of PCI or Salvage procedure||6.02||5.67–
|Shock within 24 h or at start of PCI||4.39||4.13–
|Shock within 24 h and at start of PCI||5.22||4.56–
|Cardiac arrest within 24 h of PCI||1.75||1.66–
|Lytics before PCI for STEMI||1.12||1.04–
|Pre-PCI Hb (Hb ≤13 g/dl)∗||0.80||0.79–
|Pre-PCI Hb (Hb >13 g/dl)∗||1.11||1.10–
|2- or 3-vessel disease vs. no disease or 1-vessel disease||1.23||1.20–
|SCAI lesion class II or III||1.25||1.22–
|SCAI lesion class IV||1.43||1.37–
|Pre-procedure TIMI flow grade = 0||1.24||1.20–
|Left main PCI||1.43||1.35–
|Subacute stent thrombosis||1.61||1.44–
|Proximal LAD PCI||1.10||1.07–
|Chronic kidney disease||No||Mild||Moderate||Dialysis|
|Cardiac arrest within 24 h||No||Yes|
|Hb||Hb <13||13 ≤Hb <15||Hb ≥15|
|Total Points||Risk of Bleeding, %|
This Terms of Service and License Agreement constitutes a legal agreement (collectively, the "Agreement") between the American College of Cardiology Foundation ("ACCF") and You and your agents ("You") for the use of the CathPCI Bleeding Risk Calculator (the "Product"), whether You use the mobile application version of the Product or the web version of the Product. The Product allows You to access certain content included in the Product ("Content") relating to calculation of experiencing a bleed event post percutaneous coronary intervention procedure.
By using the Product, You accept and agree to be bound by all of the terms and conditions set forth in this Agreement. If You do not wish to accept the terms and conditions of this Agreement, You may not proceed to use the Product.
ACCF may change the terms of this Agreement from time to time without further notice directly to You. When the terms are changed, ACCF will post a general conspicuous notice. If You do not agree with the revised terms, please discontinue use of the Product immediately. Your continued use of the Product following such notice constitutes your acceptance of and agreement to be bound by any revised terms of the Agreement. This Agreement expressly incorporates by reference and includes rules or disclaimers that may be posted and updated within the Product or communicated to You from time to time.
ACCF may terminate your access and/or the Product at any time. You agree that any termination of your access to the Product shall not result in any liability or other obligation of ACCF to You, or any third party in connection with such termination.
This Product, including the information, text, graphics, images, audio and video files, trademarks and other materials that may be contained therein (collectively "Content"), is owned by ACCF and/or its suppliers and is protected by patents, copyrights, trademarks, and other proprietary rights. Except as specifically provided in this Agreement, your use of the Product shall be governed and constrained by applicable patent, copyright, trademark and other intellectual property laws. ACCF grants You a limited, nonexclusive, nontransferable, revocable license to utilize and access the Product for your noncommercial, personal use according to the terms and conditions in this Agreement. You may not modify, publish, transmit, participate in the transfer or sale of, reproduce, create derivative works from, distribute, perform, display, incorporate into another website, or in any other way exploit the Service and/or any of the Content, in whole or in part. Except as expressly granted by this Agreement, You acquire no right, title or interest in the Product or the Content or other data or materials incorporated in the Product. ACCF, ACC or affiliates or licensors thereof shall retain all right, title and interest in the Product and Content.
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You assume all risks associated with use of the Product including, but not limited to any harm, injury or damages resulting directly or indirectly from the use of the Product, all such risks being known and understood by You. In consideration of your use of the Product, You, for yourself and anyone entitled to act on your behalf, waive and forever release ACCF, its officers, trustees, employees, representatives and successors from all claims and liabilities of any kind arising out of your use or misuse of the Product.
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THE PRODUCT AND CONTENT ARE PROVIDED ON AN "AS IS" AND "AS AVAILABLE" BASIS. ACCF AND ITS SUPPLIERS EXPRESSLY DISCLAIM ALL WARRANTIES OF ANY KIND WITH RESPECT TO THE PRODUCT OR CONTENT, WHETHER EXPRESS OR IMPLIED, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE AND NON-INFRINGEMENT. ACCF MAKES NO WARRANTY THAT THE PRODUCT AND/OR ANY CONTENT THEREIN WILL MEET YOUR REQUIREMENTS, OR WILL BE UNINTERRUPTED, TIMELY, SECURE, CURRENT, ACCURATE, COMPLETE OR ERROR-FREE OR THE RESULTS THAT MAY BE OBTAINED BY USE OF THE PRODUCT OR ANY CONTENT THEREIN WILL BE ACCURATE OR RELIABLE. YOU UNDERSTAND AND ACKNOWLEDGE THAT YOUR SOLE AND EXCLUSIVE REMEDY WITH RESPECT TO ANY DEFECT IN OR DISSATISFACTION WITH THE PRODUCT IS TO CEASE ITS USE.
The Content on the Product is presented as an educational service intended for licensed healthcare professionals. While the Content in the Product is about specific medical and healthcare issues, the Content is not a substitute for or replacement of personalized medical advice and is not intended to be used as the sole basis for making individualized medical or health-related decisions.
The views and opinions expressed are those of the contributing authors and editors and do not necessarily represent the views of the ACCF. The material is not intended to present the only, or necessarily best, methods or procedures for the medical situations addressed, but rather is intended to represent an approach, view, statement or opinion.
Any reference to a specific therapy or commercial product in this Product does not constitute a guarantee or endorsement by ACCF of the quality or value of such therapy or product or any claims made by the manufacturer of such therapy or commercial product. In addition, any statements about such therapy or commercial products are solely based on published clinical prediction rules and estimates of drug treatment effects from published clinical studies and do not represent an ACCF endorsement or evaluation of these products.
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This App is intended to help clinicians treating patients post-PCI. It is intended to be used by clinicians evaluating patients who are undergoing a PCI procedure for their risk of experiencing a bleeding event post procedure and to support clinical decisions regarding PCI procedures on an individual basis, integrating clinical judgment, assessment of the bleeding risk involved, and patient preference.
The App was developed by the ACC to transform cardiovascular care and improve heart health through the implementation of clinical policy at the point of care. It was developed with the review and guidance of a Work Group of ACC representatives and experts in the field, and with the oversight of the ACC Science and Quality Committee. Development of the App included several rounds of user testing within the ACC and representatives of the target audience.
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