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Background:There is scanty evidence concing the ability of Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) and Acute Catheterization and Urgent Intervention Triage Strategy and Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (ACUITY-HORIZONS) scores to predict out-of-hospital bleeding risk after percutaneous coronary interventions (PCIs) with drug-eluting stents (DES) in patients receiving dual antiplatelet therapy.We aimed to assess and compare the long-term prognostic value of these scores regarding out-of-hospital bleeding risk in such patients.Methods:We performed a prospective observational study of 10,724 patients undergoing PCI between January and December 2013 in Fuwai Hospital,China.All patients were followed up for 2 years and evaluated through the Fuwai Hospital Follow-up Center.Major bleeding was defined as Types 2,3,and 5 according to Bleeding Academic Research Consortium Definition criteria.Results:During a 2-year follow-up,245 of 9782 patients (2.5％) had major bleeding (MB).CRUSADE (21.00 [12.00,29.75] vs.18.00 [11.00,26.00],P ＜ 0.001) and ACUITY-HORIZONS (9.00 [3.00,14.00] vs.6.00 [3.00,12.00],P ＜ 0.001) risk scores were both significantly higher in the MB than non-MB groups.Both scores showed a moderate predictive value for MB in the whole study cohort (area under the receiver-operating characteristics curve [AUROC],0.565;95％ confidence interval [CI],0.529-0.601,P =0.001;AUROC,0.566;95％ CI,0.529-0.603,P ＜ 0.001,respectively) and in the acute coronary syndrome (ACS) subgroup (AUROC:0.579,95％ CI:0.531-).627,P =0.001;AUROC,0.591;95％ CI,0.544-0.638,P ＜ 0.001,respectively).However,neither score was a significant predictor in the non-ACS subgroup (P ＞ 0.05).The value of CRUSADE and ACUITY-HORIZONS scores did not differ significantly (P ＞ 0.05) in the whole cohort,ACS subgroup,or non-ACS subgroup.Conclusions:CRUSADE and ACUITY-HORIZONS scores showed statistically significant but relatively limited long-term prognostic value for out-of-hospital MB after PCI with DES in a cohort of Chinese patients.The value of CRUSADE and ACUITY-HORIZONS scores did not differ significantly (P ＞ 0.05) in the whole cohort,ACS subgroup,or non-ACS subgroup.