Risk prediction of bleeding and MACCE by PRECISE-DAPT score post-PCI

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Guidelines recommend the PRECISE-DAPT (PD) score to guide dual antiplatelet therapy (DAPT) duration based on bleeding risk.
• Emerging evidence suggests the PD score may also predict mortality and ischemic events.

Purpose of the Study:

• To investigate the predictive value of the PD score for bleeding and major adverse cardiac and cerebrovascular events (MACCE) in patients post-percutaneous coronary intervention (PCI).
• To assess the accuracy of the PD score in identifying patients at high risk for adverse outcomes.

Main Methods:

• A cohort of 994 patients undergoing PCI was analyzed.
• The PD score was correlated with established clinical scores.
• Major bleeding (Thrombolysis in Myocardial Infarction [TIMI] bleeding) and MACCE were assessed over a one-year follow-up period.

Main Results:

• Patients with a PD score ≥ 25 (47%) had significantly higher rates of major and minor bleeding compared to those with a PD score < 25.
• Higher rates of MACCE, death, and myocardial infarction were observed in the higher PD score group.
• The PD score demonstrated good discriminative ability (AUC > 0.6) for predicting bleeding, MACCE, death, and myocardial infarction.

Conclusions:

• The PD score is a valuable tool for predicting bleeding risk in post-PCI patients.
• The PD score also effectively predicts ischemic events, including death and myocardial infarction.
• While the PD score aids in optimizing DAPT duration, clinical decisions must consider individual patient risks for both bleeding and ischemic events.