Key result
Serial evaluation and recalculation of bleeding risk scores during follow-up can improve the identification of patients at higher risk of bleeding while on dual antiplatelet therapy after PCI.
Why the study?
Bleeding risk scores are conventionally computed only at the time of PCI, but bleeding risk is dynamic and can change over time, potentially leading to inappropriate antithrombotic management.
Does serial evaluation and recalculation of bleeding risk scores during follow-up improve the identification of patients at higher risk of bleeding while on DAPT after PCI?
Does serial evaluation and recalculation of bleeding risk scores during follow-up improve the identification of patients at higher risk of bleeding while on DAPT after PCI?
Serial recalculation of bleeding risk scores during follow-up after PCI may better identify patients at dynamic risk of bleeding compared to baseline assessment alone.
May aid bleeding risk stratification in PCI; leaves open whether scores improve outcomes in practice.
receptor inhibitor in patients undergoing percutaneous coronary intervention (PCI) reduces the risk of ischemic events but reduces the risk of ischemic events but increases the risk of bleeding, which in turn is associated with increased morbidity and mortality. With the aim to offer personalized treatment regimens to patients undergoing PCI, much effort has been devoted in the last decade to improve the identification of patients at increased risk of bleeding complications. Several clinical scores have been developed and validated in large populations of patients with coronary artery disease (CAD) and are currently recommended by guidelines to evaluate bleeding risk and individualize the type and duration of antithrombotic therapy after PCI. In clinical practice, these risk scores are conventionally computed at the time of PCI using baseline features and risk factors. Yet, bleeding risk is dynamic and can change over time after PCI, since patients can worsen or improve their clinical status and accumulate comorbidities. Indeed, evidence now exists that the estimated risk of bleeding after PCI can change over time. This concept is relevant, as the inappropriate estimation of bleeding risk, either at the time of revascularization or subsequent follow-up visits, might lead to erroneous therapeutic management. Serial evaluation and recalculation of bleeding risk scores during follow-up can be important in clinical practice to improve the identification of patients at higher risk of bleeding while on DAPT after PCI.
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Pelliccia et al. (2022) conducted a review in Patients on dual antiplatelet therapy after percutaneous coronary intervention. Serial evaluation and recalculation of bleeding risk scores was evaluated. Serial evaluation and recalculation of bleeding risk scores during follow-up can improve the identification of patients at higher risk of bleeding while on dual antiplatelet therapy after PCI.
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