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The Association of a PRECISE-DAPT Score With No-Reflow in Patients With ST-Segment Elevation Myocardial Infarction

Murat Selçuk1, Tufan Çınar1, Faysal Şaylık2

  • 1Department of Cardiology, Sultan II. Abdülhamid Han Training and Research Hospital, Health Sciences University, Istanbul, Turkey.

Angiology
|April 21, 2021
PubMed

Insights

The PRECISE-DAPT score, predicting bleeding complications, was significantly higher in ST-elevation myocardial infarction (STEMI) patients who experienced no-reflow after percutaneous coronary intervention (PCI). Higher scores also correlated with worse outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Research

Background:

  • ST-elevation myocardial infarction (STEMI) requires prompt reperfusion therapy.
  • Primary percutaneous coronary intervention (PCI) is the standard treatment for STEMI.
  • Predicting complications like no-reflow (NR) is crucial for patient management.

Purpose of the Study:

  • To assess the association between the PRECISE-DAPT score and the incidence of no-reflow (NR) in STEMI patients undergoing primary PCI.
  • To investigate the relationship between the PRECISE-DAPT score and adverse clinical outcomes in this patient cohort.

Main Methods:

  • Observational, retrospective study including 335 STEMI patients treated with primary PCI.
  • Patients were stratified based on a PRECISE-DAPT score of <25 versus ≥25.
  • Multivariable analysis was employed to determine independent predictors of NR.

Main Results:

  • No-reflow (NR) occurred in 8.9% of patients.
  • Patients who developed NR had a significantly higher mean PRECISE-DAPT score (20.03 vs 11.33; P = .005).
  • A PRECISE-DAPT score ≥25 was associated with increased arrhythmic complications, in-hospital shock, and mortality. The score was independently linked to NR (OR: 2.87, P = .015).

Conclusions:

  • The PRECISE-DAPT score is a significant predictor of no-reflow (NR) in STEMI patients undergoing primary PCI.
  • Higher PRECISE-DAPT scores are associated with increased risk of NR and adverse in-hospital outcomes.
  • This study provides novel insights into the utility of the PRECISE-DAPT score beyond bleeding risk prediction.

Keywords:
PRECISE-DAPT scoreSTEMIno-reflowprimary PCI

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