External Validation of the PRECISE-DAPT Cancer Score in Patients With Acute Myocardial Infarction

Area of Science:

• Cardiology
• Oncology
• Clinical Risk Prediction

Background:

• Patients with cancer undergoing treatment for acute coronary syndrome (ACS) face elevated bleeding risks.
• Existing risk scores may not adequately capture bleeding risk in cancer patients.

Purpose of the Study:

• To externally validate the PRECISE-DAPT cancer score for predicting bleeding events in patients with cancer and ACS.
• To compare its accuracy and clinical usefulness against the original PRECISE-DAPT score.

Main Methods:

• Utilized data from the BleeMACS registry, including 13,932 patients (864 with cancer).
• Compared original and cancer-specific PRECISE-DAPT scores using C-statistics, Net Reclassification Index (NRI), and decision curve analysis.

Main Results:

• The cancer score identified a higher proportion of cancer patients as high bleeding risk (HBR) (94.9% vs. 63.3%).
• Cancer score demonstrated superior discrimination (C-statistic 0.66 vs. 0.64) and a positive NRI (2.7%).
• Decision curve analysis indicated the cancer score's superiority in cancer patients.

Conclusions:

• The PRECISE-DAPT cancer score is a validated and clinically useful tool for predicting bleeding risk in ACS patients with cancer.
• It offers improved risk stratification compared to the original PRECISE-DAPT score in this population.