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Gender-related differences in changes of estimated bleeding risk in patients on dual antiplatelet therapy: the

Francesco Pelliccia1, Felice Gragnano2,3, Vincenzo Pasceri4

  • 1Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.

Platelets
|July 25, 2022
PubMed

Insights

The PRECISE-DAPT score

Area of Science:

  • Cardiology
  • Clinical Research
  • Predictive Analytics

Background:

  • The PRECISE-DAPT score predicts bleeding risk after percutaneous coronary intervention (PCI).
  • Its predictive ability may change over time and differ between sexes.
  • Understanding these dynamics is crucial for patient management.

Purpose of the Study:

  • To compare the predictive performance of the PRECISE-DAPT score at baseline versus during follow-up in male and female patients after PCI.
  • To assess how the score's ability to predict bleeding events evolves over time.

Main Methods:

  • Prospective, multicenter RE-SCORE registry.
  • Inclusion of 480 patients undergoing PCI and treated with 1-year dual antiplatelet therapy (DAPT).
  • Calculation of PRECISE-DAPT score at baseline and at 1, 4, and 8-month follow-ups.

Main Results:

  • Baseline PRECISE-DAPT scores were similar between males and females.
  • Increases in PRECISE-DAPT scores were significantly more frequent in females (44%) than males (23%).
  • Follow-up reassessment showed excellent bleeding prediction in females (c-index=0.84) but modest prediction in males (c-index=0.61).

Conclusions:

  • The bleeding predictive ability of the PRECISE-DAPT score varies over time, particularly in females.
  • Reassessing the PRECISE-DAPT score during follow-up improves its discriminative ability in females, while remaining modest in males.
  • Sex-specific monitoring of bleeding risk post-PCI is warranted.

Keywords:
BleedingDual antiplatelet therapyPercutaneous coronary intervention

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