A 4-item PRECISE-DAPT score for dual antiplatelet therapy duration decision-making
American Heart Journal Feb 05, 2020
Costa F, van Klaveren D, Colombo A, et al. - For decision-making for dual antiplatelet therapy duration after PCI, PRECISE-DAPT score, a 5-item risk score, was originally-proposed. Researchers here examined the efficacy of a simplified version of the score based on 4 factors (age, hemoglobin, creatinine clearance, prior bleeding), and lacking white-blood cell count, in guiding DAPT duration. Using the 4-item PRECISE-DAPT, they categorized 10,081 patients who were randomized to short (3–6 months) or long (12–24 months) DAPT regimen according to high (HBR defined by PRECISE-DAPT ≥ 25 points) or non-high bleeding risk (PRECISE-DAPT < 25) status. Higher bleeding rates in HBR but not in non-HBR patients, and lower ischaemic risks in non-HBR, but not in HBR patients were observed in correlation with long treatment duration. Findings support the potential utility of a 4-item simplified version of the PRECISE-DAPT score for categorizing patients who benefit from prolonged DAPT without concomitant bleeding liability from those who do not.
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