Key result
Higher PRECISE-DAPT score linked to ~1% greater long-term MACE risk per point in MINOCA patients.
Why the study?
MINOCA constitutes a significant subset of acute myocardial infarctions with uncertain prognostic markers, highlighting the need for early risk assessment tools.
Does the PRECISE-DAPT score predict in-hospital and long-term major adverse cardiovascular events in MINOCA patients presenting with acute coronary syndrome?
Observational (n=741)
No
Does the PRECISE-DAPT score predict in-hospital and long-term major adverse cardiovascular events in MINOCA patients presenting with acute coronary syndrome?
The PRECISE-DAPT score, originally designed to assess bleeding risk, independently predicts both short- and long-term major adverse cardiovascular events in MINOCA patients presenting with acute coronary syndrome.
May aid MACE risk stratification in MINOCA; leaves open prospective validation before guiding therapy.
Background: Myocardial infarction with non-obstructive coronary arteries (MINOCA) constitutes a significant subset of acute myocardial infarctions (AMI) with uncertain prognostic markers. Early risk assessment is crucial to identify MINOCA patients at risk of adverse outcomes. Objectives: This study aimed to evaluate the predictive capacity of the PRECISE-DAPT score in assessing short- and long-term prognoses in MINOCA patients presenting with ST-segment elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI). Methods: Among 741 MINOCA patients, the PRECISE-DAPT score was computed to analyze its association with inhospital and follow-up major adverse cardiovascular events (MACE). Parameters showing significance in MACE (+) groups underwent statistical analysis: univariate logistic regression for in-hospital events and univariate Cox regression for follow-up events. For statistical significance, a predefined level of α = 0.05 was adopted. Parameters demonstrating significance proceeded to multiple logistic regression for in-hospital events and multivariate Cox regression for followup events. Results: In-hospital MACE occurred in 4.1% of patients, while 58% experienced follow-up MACE. Hemoglobin levels and the PRECISE-DAPT Score were identified as independent parameters for in-hospital MACE. Furthermore, ejection fraction (EF%) and the PRECISE-DAPT Score emerged as independent predictors of follow-up MACE. Conclusions: The study revealed that a higher PRECISE-DAPT score was significantly associated with increased risks of both in-hospital and long-term major adverse cardiovascular events in MINOCA patients presenting with acute coronary syndrome (ACS), underscoring the score’s potential in risk stratification for this patient cohort.
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Onuk et al. (2024) conducted an observational in Myocardial Infarction with Non-obstructive Coronary Arteries (MINOCA) (n=741). PRECISE-DAPT score was evaluated on Long-term Major Adverse Cardiovascular Events (MACE) (HR 1.013, 95% CI 1.006-1.020, p=<0.001). A higher PRECISE-DAPT score was independently associated with an increased risk of long-term major adverse cardiovascular events (HR 1.013) in MINOCA patients presenting with acute coronary syndrome.
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