Key result
The PRECISE-DAPT score effectively predicted BARC 3 or 5 bleeding at 2 years in patients on ticagrelor monotherapy (c-index 0.67) and standard DAPT (c-index 0.63-0.66) without significant difference.
Why the study?
It was unknown whether the PRECISE-DAPT score remains valid for bleeding risk prediction in patients receiving ticagrelor monotherapy from 1 month after coronary stenting instead of standard DAPT, with or without centrally adjudicated bleeding endpoints.
Does the PRECISE-DAPT score accurately predict bleeding risk in patients receiving ticagrelor monotherapy compared to standard DAPT after coronary stenting?
Observational (n=22,062)
Does the PRECISE-DAPT score accurately predict bleeding risk in patients receiving ticagrelor monotherapy compared to standard DAPT after coronary stenting?
Effect estimate: c-index 0.67 vs 0.63 (GLOBAL LEADERS) and 0.67 vs 0.66 (GLASSY) (95% CI 0.63-0.71 vs 0.59-0.67 (GLOBAL LEADERS); 0.61-0.73 vs 0.61-0.72 (GLASSY))
p-value: p=0.27 (GLOBAL LEADERS); 0.88 (GLASSY)
The PRECISE-DAPT score is similarly effective at predicting clinically relevant bleeding in patients on ticagrelor monotherapy from 1 month after stenting compared to standard DAPT.
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PRECISE-DAPT retains predictive value with ticagrelor monotherapy; leaves open whether score-guided decisions improve outcomes.
Gragnano et al. (2020) conducted an observational in Patients on dual or single antiplatelet regimens after coronary stenting (n=22,062). PRECISE-DAPT score was evaluated on Bleeding Academic Research Consortium 3 or 5 bleeding (c-index 0.67 vs 0.63 (GLOBAL LEADERS) and 0.67 vs 0.66 (GLASSY), 95% CI 0.63-0.71 vs 0.59-0.67 (GLOBAL LEADERS); 0.61-0.73 vs 0.61-0.72 (GLASSY), p=0.27 (GLOBAL LEADERS); 0.88 (GLASSY)). The PRECISE-DAPT score effectively predicted BARC 3 or 5 bleeding at 2 years in patients on ticagrelor monotherapy (c-index 0.67) and standard DAPT (c-index 0.63-0.66) without significant difference.
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