Why the study?
The PRECISE-DAPT score is recommended for predicting out-of-hospital bleeding after PCI, but its ability to predict long-term outcomes remains unclear.
Does the PRECISE-DAPT score predict long-term MACCE and major bleeding in ACS patients who underwent PCI?
Does the PRECISE-DAPT score predict long-term MACCE and major bleeding in ACS patients who underwent PCI?
The PRECISE-DAPT score, originally designed to predict bleeding, is also an independent predictor of long-term MACCE and all-cause mortality in ACS patients post-PCI.
PRECISE-DAPT score was associated with long-term MACCE and mortality post-PCI; extends its prognostic role beyond bleeding but remains hypothesis-generating.
The PRECISE-DAPT (predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy) score is recommended for predicting out-of-hospital bleeding after percutaneous coronary intervention (PCI). However, its long-term prediction remains unclear. We investigated the performance of this score in predicting long-term outcomes in patients with the acute coronary syndrome (ACS). We divided retrospectively enrolled patients (n = 1071) into two groups according to their PRECISE-DAPT scores: low < 25 and high ≥ 25. Bleeding was assessed using the Bleeding Academic Research Consortium criteria. The ischemic endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). During follow-up (median 7.3 years), MACCE (55 vs 35%, P<.001) and major bleeding (9 vs 4%, P = .002) rates were greater in the high score group. The PRECISE-DAPT score was an independent predictor of MACCE in multivariate analysis (Hazard ratio [HR]: 1.028, 95% confidence interval [CI]: 1.016–1.039, P < .001). Also, the PRECISE-DAPT score predicted all-cause mortality (HR: 2.115, 95% CI: 1.508–2.965, P < .001) at long-term follow-up. The PRECISE-DAPT score may be useful for predicting MACCE at long-term follow-up in addition to the risk of bleeding.
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Çelik et al. (2022) studied this question.
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