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Competing Ischaemic and Bleeding Risk — EECC MCQ

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HardCoronary Artery DiseaseCompeting Ischaemic and Bleeding RiskEECC

A 75-year-old woman with NSTEMI has GRACE 165 and meets ARC-HBR criteria. Which strategy best reconciles her high ischaemic and bleeding risks?

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Correct answer: B — Use an invasive strategy with radial access and tailored antithrombotic duration

High bleeding risk does not erase the prognostic benefit of an invasive strategy in high-risk ACS. Bleeding mitigation includes radial access, renal dose adjustment, avoidance of routine bailout agents, gastroprotection where indicated and an individualised antiplatelet plan.

Reference: https://www.nice.org.uk/guidance/ng185/chapter/Recommendations