Coronary Artery Disease Scores

CREDO-Kyoto Risk Score Calculator – PCI Thrombotic and Bleeding Risk

Clinical calculation support · Verify results before clinical use

Patient characteristics

Enter findings at the time of PCI. Numeric thresholds are applied automatically.

0Thrombotic

Demographic and laboratory variables

Enter numeric values where available. Leave a field blank if unknown.

Age (years) Age ≥75 years contributes 1 thrombotic point.

eGFR (mL/min/1.73 m²) Severe CKD: eGFR <30 or maintenance dialysis.

Maintenance dialysis

Hemoglobin (g/dL) Anemia criterion: Hb <11 g/dL (thrombotic score).

Platelet count (×10³/µL) Thrombocytopenia criterion: <100 ×10³/µL (bleeding score).

Clinical history and comorbidities

Select Yes, No, or Unknown for each variable. Unknown values are handled as absent for point calculation, consistent with the original study's missing-data approach.

Atrial fibrillation

Peripheral vascular disease (PVD)

Heart failure

Diabetes mellitus

Chronic total occlusion (CTO)

Prior myocardial infarction

Malignancy

Thrombotic risk score

0 / 12

Low risk

Score 0–1: low category in the original study.

Contributing variable	Points
No positive criteria selected	0

Bleeding risk score

0 / 11

Low risk

Score 0: low category in the original study.

Contributing variable	Points
No positive criteria selected	0

Unknown or blank variables are currently counted as absent (0 points), following the original study's missing-data handling. Confirm missing clinical information before interpreting the scores.

About the CREDO-Kyoto risk scores

The CREDO-Kyoto thrombotic and bleeding risk scores are separate clinical prediction rules developed in Japanese patients undergoing percutaneous coronary intervention (PCI). The original study used 4,778 patients from CREDO-Kyoto Registry Cohort 2 for derivation and 4,669 patients from the RESET and NEXT trials for validation.

The thrombotic endpoint was a composite of myocardial infarction, definite or probable stent thrombosis, or ischemic stroke. The bleeding endpoint was GUSTO moderate or severe bleeding. The reported risk categories refer to 3-year event incidence in the validation cohort; they are not individualized probability estimates.

Score components

Thrombotic risk variable	Points	Bleeding risk variable	Points
Severe CKD	2	Thrombocytopenia	2
Atrial fibrillation	2	Severe CKD	2
Peripheral vascular disease	2	Peripheral vascular disease	2
Anemia (Hb <11 g/dL)	2	Heart failure	2
Age ≥75 years	1	Prior myocardial infarction	1
Heart failure	1	Malignancy	1
Diabetes mellitus	1	Atrial fibrillation	1
Chronic total occlusion	1	—	—

Risk categories and observed 3-year event rates

Score type	Low	Intermediate	High
Thrombotic	0–1 (2.4%)	2–3 (3.7%)	≥4 (7.6%)
Bleeding	0 (2.3%)	1–2 (4.1%)	≥3 (8.8%)

Event rates are those observed in the original validation cohort, not a guarantee of an individual patient's outcome.

Clinical notes

Severe chronic kidney disease

Defined as maintenance dialysis or eGFR <30 mL/min/1.73 m². Moderate CKD (eGFR 30–59) does not score in these original CREDO-Kyoto rules.

Thresholds

Anemia: hemoglobin <11 g/dL.
Thrombocytopenia: platelet count <100,000/µL.
Age criterion: ≥75 years.
Thresholds are strict as shown; values exactly at 11 g/dL, 100,000/µL, or eGFR 30 do not meet the corresponding criterion.

Evidence limitations

Discrimination was modest: AUC 0.68 (derivation) and 0.64 (validation) for thrombosis, and 0.66 in both cohorts for bleeding. The JCS 2020 focused update notes that predictive ability is not sufficient for the scores to be used as stand-alone decision tools.

The original publication does not provide detailed operational definitions for every clinical history variable (including PVD, heart failure, atrial fibrillation, CTO, and malignancy). Use established diagnoses documented in the patient's record; do not infer these variables.

Contemporary guidance should take precedence for clinical decisions. The 2023 ESC ACS guideline highlights ARC-HBR or PRECISE-DAPT for bleeding-risk assessment; the CREDO-Kyoto score is presented here as a separate published Japanese prediction rule, not as a substitute for currently recommended tools.

References

Natsuaki M, Morimoto T, Yamaji K, et al. Prediction of Thrombotic and Bleeding Events After Percutaneous Coronary Intervention: CREDO-Kyoto Thrombotic and Bleeding Risk Scores. J Am Heart Assoc. 2018;7(11):e008708. DOI: 10.1161/JAHA.118.008708.

Japanese Circulation Society Joint Working Groups. JCS 2020 Guideline Focused Update on Antithrombotic Therapy in Patients With Coronary Artery Disease. Circ J. 2020;84:831–865. Official publication: J-STAGE.

Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720–3826. DOI: 10.1093/eurheartj/ehad191.

Rao SV, O'Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes. Circulation. 2025;151(13):e771–e862. DOI: 10.1161/CIR.0000000000001309.

Clinical disclaimer: This calculator reproduces the published CREDO-Kyoto point-based risk rules for educational and clinical reference use. It does not diagnose a condition, provide an individualized event probability, or determine antiplatelet/anticoagulant choice or duration. The scores have modest discrimination and were developed and validated in Japanese PCI populations. Interpret results alongside the patient's full clinical context, contemporary guidelines, and clinician judgement. Unknown or missing variables are counted as absent in the point totals, which may underestimate risk.