Funding Acknowledgements Type of funding sources: None. Background PRECISE-DAPT score has become developed for predicting the risk of bleedings in patients treated with coronary stenting and subsequent 1-year dual antiplatelet therapy. The utility of PRECISE-DAPT score in the setting of all-comer CAD population with different regimes of long-term antithrombotic therapy remains unclear. Upper gastrointestinal bleeding (UGIB) is the predominant hemorrhagic complication in CAD patients; however, the PRECISE-DAPT capacity with respect to this type of bleeding has never been evaluated. Purpose to evaluate the role of PRECISE-DAPT score in the assessment of upper gastrointestinal bleeding risk in patients with stable coronary artery disease (CAD) receiving long-term antithrombotic therapy. Methods Data were obtained from single center prospective Registry of Long-term AnTithrombotic TherApy (REGATTA-1 NCT04347200). The PRECISE-DAPT score was calculated in a total of 434 patients with stable CAD (77,4% males, median age 61 [IQR 55-69] yrs). Most of the patients 93,6 % received DAPT due to recent PCI with a switch to aspirin monotherapy after 6 months. 1,4 % of patients received aspirin only, 22 (5,1%) of patients received oral anticoagulants because of concomitant atrial fibrillation. The primary outcome was any overt UGIB (BARC ≥2). Results In a total of 451 person-years of follow-up (median follow-up was 378 days, IQR 365-421), UGIB occurred 40 patients (incidence at 1 year 8.9 per 100 patients).  The median time to first occurrence of UGIB was 55 [IQR 8-115] days. Median PRECISE-DAPT score was 12 points [IQR 6; 20].  The cut-off value for PRECISE-DAPT score to predict UGIB was 16 points (AUC = 0.732, p = 0.0001, 95% CI 0.367-0.827) that correspond to at least moderate bleeding risk according to original score discrimination. Kaplan-Meier bleeding rates were separated by score cut-off (Log-Rank p < 0,001) and the risk difference remains consisted in regression model (OR 2.79 [1.07-7.29]; p = 0.0348). Conclusion(s): PRECISE DAPT score demonstrated good discriminatory capacity (cut-off 16 points) with respect to UGIB in patients with stable CAD receiving long-term antithrombotic therapy.

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Background. The rate of major bleeding in patients with atrial fibrillation receiving oral anticoagulants is 25% per year. Gastrointestinal bleedings are at least a half of major hemorrhagic complications. Currently, there is no optimal scale to calculate the risk of bleeding, and therefore the search for clinical predictors of gastrointestinal bleeding remains relevant. Aim. To assess the frequency and structure of large gastrointestinal bleeding, as well as to identify clinical predictors of their development based on long-term prospective observation of patients with atrial fibrillation receiving oral anticoagulants. Materials and methods. Data were obtained from single center prospective REGistry of long-term AnTithrombotic TherApy (REGATTA NCT043447187). Investigation based on a 20-year follow-up with 510 patients with atrial fibrillation with a high thromboembolic risk (median CHA2DS2-VASc was 4 points). The REGATTA registry assessed the frequency and structure of major gastrointestinal bleeding. Predictors of the development of 32 large gastrointestinal bleeding were identified based on the analysis of pairs with univariate and multivariate analyses. Results. The frequency of major gastrointestinal bleeding in patients with atrial fibrillation receiving oral anticoagulants at 1 year was 1.42 per 100 patients; the predominant localization was upper gastrointestinal tract. Predictors of the development of major gastrointestinal bleeding according to multiple regression data analysis were hemoglobin level 14.55 g/dL, body mass index 28.4 kg/m2, gastrointestinal ulcer or erosive lesion and major hemorrhagic complications in history of disease. In 1/2 cases the sourse of bleeding remained unclear. Conclusion. Searching for clinical predictors of gastrointestinal bleeding can identify patients receiving oral anticoagulants who is need of intensive monitoring risk factors to prevent the development of life-threatening bleeding and to provide with adequate anticoagulant therapy.