A Bleeding-Risk Score is Not a Bleeding Endpoint: DAPT De-Escalation in mGPS-High NSTEMI.

Dr. Hasan Burak İşleyenCardiology

“The 36-month all-cause mortality rate of 57.1% observed in the mGPS 2 cohort underscores a profound state of 'biological frailty.' The perfect concordance between severe systemic inflammation (mGPS 2) and high baseline bleeding risk (PRECISE-DAPT ≥25) highlights a critical mechanism: systemic inflammation is likely a shared biological driver of both catastrophic long-term mortality and heightened hemorrhagic susceptibility. Consequently, our conclusion provides a robust hypothesis-generating foundation: elevated mGPS identifies a highly vulnerable population in whom early DAPT de-escalation strategies (such as transitioning to P2Y12 inhibitor monotherapy at 1 or 3 months) urgently warrant evaluation in prospective, randomized clinical trials.”