Performance of PRECISE-DAPT Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy

Area of Science:

• Cardiology
• Clinical Risk Stratification
• Pharmacology

Background:

• Dual antiplatelet therapy (DAPT) is crucial post-coronary stenting but increases bleeding risk.
• Existing bleeding risk scores lack standardization for DAPT management.
• Comparison of PRECISE-DAPT, CRUSADE, and ACUITY scores in Korean patients is needed.

Purpose of the Study:

• To compare the predictive performance of PRECISE-DAPT, CRUSADE, and ACUITY scores for bleeding events in Korean patients receiving DAPT.
• To evaluate the utility of a new risk score, PRECISE-DAPT, in a specific patient population.

Main Methods:

• A cohort of 904 Korean patients undergoing stent implantation and DAPT was analyzed.
• One-year bleeding events were assessed using TIMI, GUSTO, and BARC criteria.
• The discriminative ability of CRUSADE, ACUITY, and PRECISE-DAPT scores was evaluated using C-statistic analysis.

Main Results:

• Bleeding events occurred in 17.0% (BARC ≥3a), 13.2% (TIMI minor/major), and 8.8% (GUSTO moderate/severe) of patients.
• All three scores demonstrated high predictive accuracy (AUCs ranging from 0.73 to 0.82) for bleeding events.
• PRECISE-DAPT showed comparable discrimination to CRUSADE and ACUITY but superior reclassification of bleeding risk.

Conclusions:

• The PRECISE-DAPT score serves as a standardized and simple tool for predicting 1-year bleeding risk in Korean patients on DAPT.
• Its performance is robust across different bleeding definitions.
• PRECISE-DAPT aids in risk stratification and management of bleeding complications in this patient group.