A PRECISE-DAPT score ≥25 was associated with a significantly higher incidence of in-hospital new-onset atrial fibrillation compared to a score <25 (28.7% vs 2.9%; P<0.001).
Cohort (n=2,234)
Does a higher PRECISE-DAPT score predict new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction?
The PRECISE-DAPT score, originally designed to predict bleeding risk, is also independently associated with the development of in-hospital new-onset atrial fibrillation in patients with STEMI undergoing primary PCI.
Odds Ratio: 1.04 (95% CI 1.1–1.18)
Absolute Event Rate: 28.7% vs 2.9%
p-value: p=<0.001
Background: Atrial fibrillation (AF) is associated with increased morbidity in myocardial infarction (MI), especially thromboembolic risk increases. The PRECISE-DAPT (The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy) score was created to predict the bleeding risk of dual antiplatelet therapy. The purpose of this study was to evaluate the association between new-onset AF and the PRECISE-DAPT score in ST-segment-elevation myocardial infarction (STEMI). Methods: This retrospective study enrolled patients who developed STEMI within 12 hours of the onset of symptoms and underwent primary percutaneous coronary intervention. The study population was divided into 2 groups of PRECISE-DAPT scores of 25 or greater and PRECISE-DAPT scores of below 25 and their baseline characteristics, as well as laboratory and echocardiography results, were compared. In-hospital new AF and related events were compared between the 2 PRECISE-DAPT score groups. Results: From February 2015 to December 2017, this study enrolled 2234 patients with STEMI at a mean age of 54.4 years. The new-onset AF incidence rate was higher in the higher PRECISE-DAPT group than in the lower PRECISE-DAPT group (62 28.7 % vs 58 2.9%; P<0.001). According to the multivariate logistic regression analysis, the factors associated with new-onset AF were the left atrial diameter (OR=1.98, 95% confidence interval=1.34–2.93; P=0.001) and the PRECISE-DAPT score (OR=1.04, 95% confidence interval=1.10–1.18; P<0.001). Conclusion: The PRECISE-DAPT score was associated with the development of new-onset AF in our patients with STEMI. Further follow-up of these patients will provide clearer information.
Pamukçu et al. (Sun,) conducted a cohort in ST-segment-elevation myocardial infarction (STEMI) (n=2,234). PRECISE-DAPT score ≥25 vs. PRECISE-DAPT score <25 was evaluated on In-hospital new-onset atrial fibrillation (OR 1.04, 95% CI 1.10-1.18, p=<0.001). A PRECISE-DAPT score ≥25 was associated with a significantly higher incidence of in-hospital new-onset atrial fibrillation compared to a score <25 (28.7% vs 2.9%; P<0.001).
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