Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials

Abstract

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More, More, More: Reducing Thrombosis in Acute Coronary Syndromes Beyond Dual Antiplatelet Therapy—Current Data and Future Directions

“…Risk scores are available and may be considered to identify patients at high bleeding risk 38. The PRECISE‐DAPT (Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy)40 or PARIS (Patterns of Nonadherence to Antiplatelet Regimen in Stented Patients)41 scores in patients receiving coronary stents and treated with DAPT have been shown to be predictive of bleeding, but prospective validation in randomized controlled trials is lacking 38. Other risk scores for bleeding can be helpful, including HASBLED (Hypertension, Abnormal liver/renal function, Stroke history, Bleeding predisposition, Labile international normalized ratio, Elderly, Drug/alcohol usage),42 validated predominantly in patients with atrial fibrillation taking warfarin, or CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) scores in ACS patients undergoing coronary angiography 43, 44.…”

Dual Antiplatelet Therapy (DAPT) in Coronary Artery Disease: A Daunting Dilemma

“…The predictive performance of this tool was assessed in the derivation cohort and validated in 8595 patients from the PLATO trial and 6172 patients from BernPCI registry. In comparison with PARIS bleeding score, this tool demonstrated good discrimination and net reclassification of patients 80 .…”

Uso de terapia antiagregante dual luego de angioplastía coronaria. Duración, frecuencia de sangramientos y validación de scores de riesgo de hemorragia en una cohorte chilena

“…Cabe destacar, sin embargo, que el DAPT score fue diseñado para evaluar el riesgo de sangrado en pacientes que ya han recibido TAD por 1 año sin inconvenientes. Más recientemente, un nuevo puntaje llamado PRECISE-DAPT ha sido propuesto y validado 7 . Este puntaje incluye 5 variables (Tabla 1) cuya integración en un normograma permite discriminar entre pacientes con riesgo bajo (puntaje <25), riesgo moderado (21-25) y riesgo alto (>25) de sangrado con el uso de TAD.…”