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Five-Year Prognostic Value of DAPT Score in Older Patients undergoing Percutaneous Coronary Intervention: A

Kailun Yan1, Pei Zhu1, Xiaofang Tang1

  • 1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College.

Journal of Atherosclerosis and Thrombosis
|May 31, 2023
PubMed

Insights

The DAPT score did not predict major adverse cardiovascular events in older patients after PCI. However, it showed some predictive value for major bleeding events over a 5-year period.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Geriatric Medicine

Background:

  • The dual-antiplatelet therapy (DAPT) score is utilized to assess risks in patients undergoing percutaneous coronary intervention (PCI).
  • Its prognostic value in older populations (≥ 65 years) requires further investigation.

Purpose of the Study:

  • To evaluate the long-term predictive capability of the DAPT score for ischemic events and bleeding in elderly patients post-PCI.
  • To determine if the DAPT score is a reliable prognostic tool for this specific demographic.

Main Methods:

  • A cohort of 10,724 patients who underwent PCI was analyzed, with a focus on 2,981 patients aged 65 years or older.
  • Major adverse cardiovascular and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) bleeding were tracked over a 5-year follow-up period.
  • Multivariate Cox regression and ROC curve analysis were employed to assess the DAPT score's prognostic value.

Main Results:

  • The DAPT score did not significantly predict MACCE (AUROC: 0.534, P=0.079) in older PCI patients.
  • A higher DAPT score (≥ 2) was associated with a significantly increased risk of BARC 2, 3, or 5 bleeding (HR: 2.447, P=0.002).
  • The DAPT score demonstrated a certain prognostic value for predicting bleeding events (AUROC: 0.646, P<0.001).

Conclusions:

  • The DAPT score is not a reliable predictor of ischemic events (MACCE) in elderly patients following PCI.
  • The DAPT score shows a degree of predictive utility for identifying older PCI patients at higher risk of significant bleeding over a 5-year period.
Abstract

Keywords:
DAPT scoreMACCEPCIbleedingolder

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