Association Between PRECISE-DAPT Score and Thrombus Burden in Patients With ST-Segment Elevation Myocardial Infarction

Background: Acute coronary syndrome (ACS), particularly ST segment elevation myocardial infarction (STEMI), develops from complete coronary occlusion causing myocardial ischemia and necrosis. Elevated blood viscosity promotes thrombosis. The PRECISE-DAPT score could predict bleeding risk among dual antiplatelet therapy patients. We aimed in this research to assess the association between PRECISE-DAPT score and thrombus burden among STEMI patients, evaluating its predictive value for thrombotic load. Methods: We performed this cross-sectional study on 122 STEMI patients undergoing primary PCI. Eligible patients had complete data for score calculation and angiographic thrombus grading. Standard clinical, laboratory, echocardiographic, and PCI protocols were followed. Thrombus burden was classified by angiography, and its correlation with PRECISE-DAPT scores was analyzed to evaluate thrombotic risk prediction. Results: Patients who had higher PRECISE-DAPT scores were statistically significantly older (P=0.0084) and statistically significantly received Plavix (P=0.013). They exhibited statistically significantly higher angiographic thrombus burden (P<0.0001) and poorer pre- and post-treatment Thrombolysis in Myocardial Infarction (TIMI) flow, TIMI myocardial perfusion grade (TMPG) and frame count values (P<0.0001 and P=0.0054, respectively). Clinical outcomes showed statistically significantly higher rates of heart failure (P=0.0003) and re-infarction (P=0.0002) in this group. Univariable analysis identified age (P=0.028) and PRECISE-DAPT score (P<0.0001) as significant predictors of high thrombus burden, while multivariable regression confirmed the PRECISE-DAPT score as an independent predictor (P<0.0001). Conclusion: Higher PRECISE-DAPT scores predicted greater thrombus burden and worse outcomes, serving as an independent ischemic risk marker.