Validation of the Asian-Dual Antiplatelet Therapy Score

An individualized approach is recommended for prescribing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Asian-DAPT (ADAPT) scores were developed to assess both ischemic and bleeding risks in Asian populations. This study aimed to validate the ADAPT scores for predicting ischemic and bleeding events in patients receiving DAPT.

Patients from the Multicenter Registry of KOrean PCI foR Endpoint Analysis registry were analyzed. The ADAPT scores, comprising the ischemic-ADAPT (I-ADAPT), bleeding-ADAPT (B-ADAPT), and Net-ADAPT scores, were calculated using clinical and angiographic parameters. Co-primary endpoints included ischemic outcomes (cardiovascular death, myocardial infarction, and stent thrombosis) and bleeding outcomes (major and minor bleeding).

A total of 4,657 patients were included in analysis. The mean age was 63.8±11.1 years, and 72.3% were male. During a median follow-up of 368 days, ischemic outcomes occurred in 0.9% (43 patients), and bleeding outcomes in 0.9% (44 patients). The I-ADAPT and B-ADAPT scores had significant predictive values for ischemic outcomes (C-statistic=0.672; 95% confidence interval [CI], 0.585-0.758; p<0.001) and bleeding outcomes (C-statistic=0.715; 95% CI, 0.642-0.789; p<0.001), respectively. Regarding the Net-ADAPT score, patients with a score >0 were at a 1.7-fold higher risk of ischemic events, while those with a score of <0 had a 1.3-fold higher risk of bleeding events.

The ADAPT scores were validated for predicting ischemic and bleeding risks in patients receiving DAPT. This scoring system can aid in evaluating both ischemic and bleeding risks for East Asians, who exhibit unique risk profiles.