DAPT Score to Stratify Ischemic and Bleeding Risk after Percutaneous Coronary Intervention: An Updated Systematic Review, Meta-Analysis, and Meta-Regression of 100,211 Patients

Montalto, Claudio; Ferlini, Marco; Casula, Matteo; Mandurino-Mirizzi, Alessandro; Costa, Francesco; Leonardi, Sergio; Visconti, Luigi Oltrona

doi:10.1055/s-0040-1721145

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…After its development in the DAPT trial, the DAPT score has been extensively investigated with regard to its ability to stratify ischemic risk in a wide variety of patient groups who have received PCI (8)(9)(10)(11). Most of the studies confirmed that patients with a high DAPT score have a higher incidence of ischemic events when compared with patients with a low DAPT score.…”

Section: Discussionmentioning

confidence: 99%

“…For patients with a high DAPT score (≥2), who had an increased ischemic risk, treatment with extended DAPT beyond 1 year resulted in a reduction in ischemic events but without an increase in bleeding (7). The DAPT score has been validated as useful for stratifying ischemia and bleeding risk in other patient groups, including Asian patients, outside the derivation cohort of the DAPT trial (8)(9)(10). Although there were some controversial results regarding its discriminating ability in one study (11), the DAPT score seems to be a clinically useful tool for determining DAPT duration after PCI.…”

Section: Introductionmentioning

confidence: 99%

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Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy

Huang

Chen

Feng

et al. 2022

Front. Cardiovasc. Med.

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BackgroundDual antiplatelet therapy (DAPT) score is used to stratify ischemic and bleeding risk for antiplatelet therapy after percutaneous coronary intervention (PCI). This study assessed the association between the DAPT score and clinical outcomes in acute coronary syndrome (ACS) patients who were treated with P2Y12 inhibitor monotherapy.MethodsA total of 498 ACS patients, with early aspirin discontinuation for various reasons and who received P2Y12 inhibitor monotherapy after PCI, were enrolled during the period from January 1, 2014 to December 31, 2018. The efficacy and safety between those with low (<2) and high (≥2) DAPT scores were compared during a 12-month follow-up after PCI. Inverse probability of treatment weighting was used to balance the covariates between the two groups. The primary endpoint was a composite outcome of all-cause mortality, recurrent ACS or unplanned revascularization, and stroke within 12 months. The safety endpoint was major bleeding, defined as Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding.ResultsThe primary composite endpoint occurred in 11.56 and 14.38% of the low and high DAPT score groups, respectively. Although there was no significant difference in the primary composite endpoint between the two groups in the multivariate Cox proportional hazards models, the risk of recurrent ACS or unplanned revascularization was significantly higher in the high DAPT score group (adjusted hazard ratio [HR]: 1.900, 95% confidence interval [CI]: 1.095–3.295). The safety outcome for BARC 3 or 5 bleeding was similar between the two groups.ConclusionsOur results indicate that ACS patients receiving P2Y12 monotherapy with high DAPT score had an increased risk of recurrent ACS or unplanned revascularization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy

Huang

Chen

Feng

et al. 2022

Front. Cardiovasc. Med.

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show abstract

“…In contrast, Ueda et al showed that in an extensive Swedish registry, this score did not effectively discriminate between bleeding and ischemic risk [ 38 ]. In a recent analysis, including 100,211 post-PCI patients, a DAPT score ≥2 was able to accurately recognize patients at high ischemic and low bleeding risk [ 39 ].…”

Section: Residual Risk In Chronic Coronary Syndromesmentioning

confidence: 99%

Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention

Giubilato,

Lucà,

Abrignani

et al. 2023

JCM

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Chronic coronary syndrome (CCS), which encompasses a broad spectrum of clinical presentations of coronary artery disease (CAD), is the leading cause of morbidity and mortality worldwide. Recent guidelines for the management of CCS emphasize the dynamic nature of the CAD process, replacing the term “stable” with “chronic”, as this disease is never truly “stable”. Despite significant advances in the treatment of CAD, patients with CCS remain at an elevated risk of major cardiovascular events (MACE) due to the so-called residual cardiovascular risk. Several pathogenetic pathways (thrombotic, inflammatory, metabolic, and procedural) may distinctly contribute to the residual risk in individual patients and represent a potential target for newer preventive treatments. Identifying the level and type of residual cardiovascular risk is essential for selecting the most appropriate diagnostic tests and follow-up procedures. In addition, new management strategies and healthcare models could further support available treatments and lead to important prognostic benefits. This review aims to provide an overview of the diagnostic and therapeutic challenges in the management of patients with CCS and to promote more effective multidisciplinary care.

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Rationale and design of the PARTHENOPE trial: A two-by-two factorial comparison of polymer-free vs biodegradable-polymer drug-eluting stents and personalized vs standard duration of dual antiplatelet therapy in all-comers undergoing PCI

Piccolo¹,

Calabrò

Varricchio³

et al. 2023

American Heart Journal

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DAPT Score to Stratify Ischemic and Bleeding Risk after Percutaneous Coronary Intervention: An Updated Systematic Review, Meta-Analysis, and Meta-Regression of 100,211 Patients

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Cited by 3 publications

References 13 publications

Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy

Impact of the Dual Antiplatelet Therapy Score on Clinical Outcomes in Acute Coronary Syndrome Patients Receiving P2Y12 Inhibitor Monotherapy

Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention

Rationale and design of the PARTHENOPE trial: A two-by-two factorial comparison of polymer-free vs biodegradable-polymer drug-eluting stents and personalized vs standard duration of dual antiplatelet therapy in all-comers undergoing PCI

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