• Patients presenting with Non-ST-Elevation Myocardial Infarction (NSTEMI) or Unstable Angina (UA)
• To stratify the risk of major, in-hospital bleeding prior to initiating antithrombotic therapy and making decisions regarding invasive management

The CRUSADE score is a weighted algorithm using 8 baseline variables (4 continuous, 4 categorical) routinely collected at presentation. Points are assigned non-linearly based on the independent predictive power of each variable for major bleeding.

• Baseline Hematocrit (%): Severe anemia significantly increases bleeding risk points (<31.5% = 44 pts).
• Creatinine Clearance (mL/min): Severe renal impairment drives risk (≤15 mL/min = 39 pts).
• Heart Rate (bpm): Tachycardia correlates with worse outcomes.
• Systolic BP (mmHg): Both extremes (≤90 and ≥201) carry points.
• Female Sex: Carries 8 points.
• Signs of CHF at presentation: Carries 7 points.
• Prior Vascular disease and Diabetes mellitus: Carry 6 points each.

• ≤20: Very Low Risk (3.1%)
• 21-30: Low Risk (5.5%)
• 31-40: Moderate Risk (8.6%)
• 41-50: High Risk (11.9%)
• >50: Very High Risk (19.5%)

• Dose adjustment of antithrombotics based on renal function and weight
• Choice of anticoagulation (e.g., preferring fondaparinux or bivalirudin over unfractionated heparin in certain settings depending on local protocols)
• Preferential use of radial rather than femoral arterial access for angiography/PCI
• Routine use of proton-pump inhibitors (PPIs) in patients at high risk of GI bleed