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The Relationship Between PRECISE-DAPT Score and Spontaneous Reperfusion of Infarct-Related Artery in Patients with
Taner Şeker1, Caner Türkoğlu2, Ömer Genç3
1Department of Cardiology, Health Sciences University, Adana Training and Research Hospital, Adana, Türkiye.
Insights
Spontaneous reperfusion in ST-segment elevation myocardial infarction patients is predicted by the PRECISE-DAPT score. A higher PRECISE-DAPT score indicates a lower likelihood of spontaneous reperfusion, impacting clinical outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Acute Coronary Syndromes
Background:
- Spontaneous reperfusion (SR) and a low PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score are linked to better outcomes in acute coronary syndrome (ACS).
- Understanding the relationship between SR and the PRECISE-DAPT score is crucial for managing STEMI patients.
Purpose of the Study:
- To investigate the association between spontaneous reperfusion (SR) and the PRECISE-DAPT score in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).
Main Methods:
- A total of 436 STEMI patients undergoing primary PCI were analyzed.
- Spontaneous reperfusion was defined as TIMI III blood flow in the infarct-related artery before PCI.
- The PRECISE-DAPT score was calculated for all patients.
Main Results:
- Patients with SR had lower hyperlipidemia rates and higher ejection fractions.
- Patients without SR showed higher glucose, troponin, CK-MB, and PRECISE-DAPT scores.
- Absence of SR was associated with increased no-reflow and higher SYNTAX-I scores.
- A high PRECISE-DAPT score independently predicted the absence of SR (OR 0.96, P=0.04).
Conclusions:
- The PRECISE-DAPT score is an independent predictor of spontaneous reperfusion in STEMI patients.
- This finding may help refine risk stratification and treatment strategies for STEMI patients.
Objective:
Spontaneous reperfusion (SR) presence and a low PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti Platelet Therapy (PRECISE-DAPT) score in patients with acute coronary syndrome have been associated with favorable clinical outcomes. This study aimed to investigate the relationship between SR and this score.
Methods:
The study included 436 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Thrombolysis in myocardial infarction (TIMI) III blood flow presence in the infarct-related artery (IRA) before primary percutaneous coronary intervention (PCI) was defined as SR. Patients were categorized into two groups based on the presence (n = 49) or absence (n = 387) of SR. The PRECISE-DAPT score was computed for each patient using the web-based calculator.
Results:
The group with SR had a lower frequency of hyperlipidemia and a higher ejection fraction (EF) at admission. Conversely, the group without SR presented with higher values of glucose, troponin, creatine kinase-myocardial band (CK-MB), and PRECISE-DAPT score. The no-reflow phenomenon and elevated SYNergy between PCI with TAXUS and Cardiac Surgery (SYNTAX-I) scores were higher in the group without SR than in the one with SR. Multivariate regression analysis indicated that a high PRECISE-DAPT score was an independent predictor of the absence of SR (odds ratio: 0.96, P = 0.04).
Conclusion:
The PRECISE-DAPT score is an independent predictor of the presence of spontaneous reperfusion in patients who experienced STEMI.
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