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Prediction of Bleeding by the PRECISE-DAPT Score in Patients with Carotid Artery Stenting
Leyla Ramazanoglu1, Isil Kalyoncu Aslan2, Ahmet Bugrul3
1Department of Neurology, University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey. afleylaak@hotmail.com.
Insights
The PRECISE-DAPT score effectively predicts bleeding risk in patients undergoing carotid artery stenting (CAS). A higher score (≥25) correlated with significantly increased bleeding events after dual antiplatelet therapy.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Clinical Risk Assessment
Background:
- Dual antiplatelet therapy (DAPT) is standard after percutaneous coronary interventions (PCIs) and carotid artery stenting (CAS).
- The PRECISE-DAPT score is validated for predicting bleeding risk in PCI patients on DAPT.
- Its utility in CAS patients, who also receive DAPT, requires investigation.
Purpose of the Study:
- To evaluate the PRECISE-DAPT score's performance in predicting bleeding complications in patients undergoing CAS.
- To compare bleeding and ischemic events between low and high PRECISE-DAPT score groups in CAS patients.
Main Methods:
- Retrospective analysis of 120 patients who underwent CAS between January 2018 and December 2020.
- Calculation of the PRECISE-DAPT score for all patients.
- Stratification into low (<25) and high (≥25) score groups for comparative analysis of outcomes.
Main Results:
- A total of 120 patients (mean age 67.3 years) were analyzed.
- Forty-three patients had high PRECISE-DAPT scores (≥25), and 77 had low scores (<25).
- Six bleeding events occurred within six months, with five in the high-score group (P=0.022), indicating a significant difference.
Conclusions:
- The PRECISE-DAPT score demonstrates potential utility in predicting bleeding risk for patients undergoing CAS.
- Patients with a PRECISE-DAPT score of 25 or higher experienced a significantly higher rate of bleeding events.
Purpose:
The predicting bleeding complications in patients undergoing stent implantation and the subsequent dual antiplatelet therapy (PRECISE-DAPT) score predicts the risk of bleeding in patients with dual antiplatelet therapy (DAPT) after percutaneous coronary interventions (PCIs). Patients with carotid artery stenting (CAS) are also treated with DAPT. In this study, we aimed to investigate the performance of the PRECISE-DAPT score in predicting bleeding in patients with CAS.
Methods:
Patients who had CAS between January 2018 and December 2020 were retrospectively enrolled. The PRECISE-DAPT score was calculated for each patient. The patients were divided into two groups based on their PRECISE-DAPT score: low < 25 and high ≥ 25. Bleeding and ischemia complications and laboratory data among the two groups were compared.
Results:
A total of 120 patients with a mean age of 67.3 ± 9.7 years were included. Forty-three patients had high PRECISE-DAPT scores, and 77 patients had low PRECISE-DAPT scores. Six patients developed bleeding events during the six-month follow-up, and five of them were in the PRECISE DAPT score ≥ 25 group. The difference between the two groups regarding bleeding events at six months was significant (P = 0.022).
Conclusion:
The PRECISE-DAPT score might be used for predicting the bleeding risk in patients with CAS, and the bleeding rate was significantly higher in patients with a PRECISE-DAPT score ≥ 25.
