The clinical value of the PRECISE-DAPT score in predicting long-term MACCE and major bleeding in acute coronary syndrome patients underwent percutaneous coronary intervention

Background: The PRECISE-DAPT (predicting bleeding complications in patients undergoing stent implantation and subsequent dualantiplatelet therapy) score is recommended by guidelines for predicting out-of-hospital bleeding in patients after percutaneous coronary intervention (PCI). However, the long-term prognostic value of the PRECISE-DAPT score and long- term predictive value for major bleeding of this score in patients after PCI remains unclear. we aimed to investigate the performance of the PRECISE-DAPT score in predicting the long-term outcomes in patients with acute coronary syndromes (ACS). Methods : We enrolled retrospectively 1071 ACS patients in presented study. We divided the patients into two groups according to the their PRECISE-DAPT scores: the low (PRECISE-DAPT < 25), and high (≥ 25) score groups. The bleeding endpoint was Bleeding Academic Research Consortium 2, 3, or 5 bleeding. The ischaemic endpoints were all cause death and major adverse cardiovascular and cerebrovascular events (MACCE). Results: During the follow-up period ( median 7.3 years), the rates of MACCE (55% vs 35%, p < 0.001) and major bleeding ( 9% vs 4%, p = 0.002) were higher in high score group than in low score group. PRECISE-DAPT score was an independent predictor of MACCE in multivariate analysis (HR:1.030, 95%CI: 1.020-1.040, p < 0.001). PRECISE-DAPT score showed a moderate predictive values for both MACCE with an areas under the curve (AUC) of 0.626 (95% CI: 0.592–0.660) and major bleeding with an AUC of 0.609 (95% CI: 0.515– 0.713). Conclusions: In ACS patients underwent PCI, a high PRECISE-DAPT score was related to higher MACCE rates. PRECISE-DAPT score is useful for predicting MACCE at long-term follow-up in addition to risk stratification of bleeding.