Key result
DAPT score fails to predict ischemic and bleeding risks in post-PCI patients.
Why the study?
Previous studies showed discrepancy regarding the predictive ability of the DAPT score for quantifying ischemic and bleeding risks.
Does the DAPT score discriminate the risks of ischemic and bleeding events in patients who are event-free 12 months post-PCI?
Cohort (n=9,114)
No
Does the DAPT score discriminate the risks of ischemic and bleeding events in patients who are event-free 12 months post-PCI?
In a large real-world cohort of PCI patients, the DAPT score did not effectively discriminate the risks of ischemic and bleeding events between 12 and 24 months.
DAPT score does not discriminate ischemic or bleeding risks in real-world post-PCI patients; leaves open need for better stratification tools before guiding extended DAPT.
Dual antiplatelet therapy (DAPT) score emerged as a tool for quantification of ischemia and bleeding risks. However, there was discrepancy of the prediction ability of DAPT score in previous studies. We aimed to assess the utility of DAPT score in a large-scale cohort of consecutive percutaneous coronary intervention (PCI) patients. This study enrolled 9,114 patients who had undergone PCI at Fuwai Hospital in 2013, adhered to DAPT and were event-free within the first 12 months following PCI. The endpoints included primary ischemic endpoints (major adverse cardiovascular and cerebrovascular events, and myocardial infarction and/or stent thrombosis), and bleeding endpoint from 12 through 24 months after PCI. Patients were classified into low (score <2, n = 3,989) and high (score ≥2, n = 5,125) DAPT score groups. The incidence rates of primary ischemic endpoints and bleeding endpoint were similar between the two groups. Multivariable analysis demonstrated DAPT score not to be an independent predictor of primary ischemic endpoints or bleeding endpoint. Based on receiver operating characteristic curves analysis, the C-statistic of DAPT score for primary ischemic endpoints or bleeding endpoint did not achieve a significant extent. In this large-scale cohort of PCI patients, DAPT score did not discriminate the risks of ischemic and bleeding events.
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Gao et al. (2020) conducted a cohort in Post-PCI patients on DAPT (n=9,114). High DAPT score (≥2) vs. Low DAPT score (<2) was evaluated on Primary ischemic endpoints (major adverse cardiovascular and cerebrovascular events, and myocardial infarction and/or stent thrombosis), and bleeding endpoint. The DAPT score did not independently predict or discriminate the risks of primary ischemic and bleeding events between high (≥2) and low (<2) score groups in 9,114 post-PCI patients.
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