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The PRECISE-DAPT score and 5-year outcomes after percutaneous coronary intervention: a large-scale, real-world study

Xueyan Zhao1, Jiawen Li1, Fangchao Liu1

  • 1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.

European Heart Journal. Quality of Care & Clinical Outcomes
|September 24, 2021
PubMed

Insights

The PRECISE-DAPT score effectively predicts long-term bleeding and death in patients after percutaneous coronary intervention (PCI). This score offers valuable prognostic insights for managing patients undergoing stent implantation and dual-antiplatelet therapy.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Risk Prediction

Background:

  • The PRECISE-DAPT score is guideline-recommended for predicting out-of-hospital bleeding post-percutaneous coronary intervention (PCI).
  • The long-term prognostic value of the PRECISE-DAPT score in patients after PCI requires further investigation.

Purpose of the Study:

  • To evaluate the long-term prognostic value of the PRECISE-DAPT score for bleeding and ischemic events in patients after PCI.
  • To assess the predictive accuracy of the PRECISE-DAPT score over a 5-year follow-up period.

Main Methods:

  • A prospective study of 10,724 patients undergoing PCI in 2013.
  • 5-year follow-up analyzing bleeding (BARC 2, 3, or 5) and ischemic endpoints (all-cause death, MACCE).
  • Cox regression and C-statistic analysis were used to assess the predictive value.

Main Results:

  • Among 10,109 analyzed patients, 4.11% experienced bleeding, 3.60% all-cause death, and 20.27% MACCE.
  • High PRECISE-DAPT score was significantly associated with increased risks of bleeding (HR: 1.721), MACCE (HR: 1.607), and all-cause death (HR: 3.902).
  • The score demonstrated prognostic value for 5-year bleeding (C-statistic: 0.566), MACCE (C-statistic: 0.540), and all-cause death (C-statistic: 0.673).

Conclusions:

  • The PRECISE-DAPT score has significant 5-year predictive value for long-term bleeding events in Chinese patients post-PCI.
  • The score also exhibits moderate prognostic value for predicting all-cause death and MACCE in this population.
Abstract

Keywords:
BleedingDeathMajor adverse cardiovascular and cerebrovascular eventsPRECISE-DAPT scorePercutaneous coronary intervention

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