External Validation of the DAPT Score in a Nationwide Population

Ueda, Peter; Jernberg, Tomas; James, Stefan; Alfredsson, Joakim; Erlinge, David; Ömerovic, Elmir; Persson, Jonas; Ravn-Fischer, Annica; Tornvall, Per; Svennblad, Bodil; Varenhorst, Christoph

doi:10.1016/j.jacc.2018.06.023

Cited by 67 publications

(59 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7,8 Several previous reports assessed the external validation of the DAPT score in the real-world population, but this scoring system could not be generalized to real-world practice. 15,16 In the present study, patients' clinical variables were not associated with E-DAPT, but lesion complexity, such as LM PCI or complex PCI, was a major independent determinant of E-DAPT. Furthermore, the DAPT and PRECISE-DAPT scores were similar between the 2 groups.…”

Section: Clinical Outcomesmentioning

confidence: 48%

Long-Term Safety and Efficacy of Extended Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Real-World Practice

Kang

et al. 2020

Circ J

View full text Add to dashboard Cite

However, there are limited data about the long-term safety and efficacy of extended DAPT after DES implantation in such high-risk patients in real-world practice. In addition, the ability of randomized clinical trials to reflect real-world practice, in which high-risk procedures are usually performed, may be limited. Thus, the aim of the present study was to evaluate the major determinants and long-term outcomes of extended DAPT after DES implantation in real-world practice. Methods Study Population and Data Collection We reviewed the clinical data, retrieved from the medical database of Yeungnam University Medical Center percutaneous coronary intervention (PCI) registry, of 1,707 patients with coronary artery disease who underwent DES

show abstract

Section: Clinical Outcomesmentioning

confidence: 48%

Long-Term Safety and Efficacy of Extended Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Real-World Practice

Kang

et al. 2020

Circ J

View full text Add to dashboard Cite

show abstract

“…Our search of MEDLINE and EMBASE yielded 81 results (Figure 1). After detailed review of titles and abstracts and full manuscripts of potentially relevant papers a total of 13 studies were included 8,12‐16,18‐24 …”

Section: Resultsmentioning

confidence: 99%

“…In Yoshikawa et al study 76.7% of patients remained on DAPT beyond 13 months 14 . However, several of the included studies did not specify the treatment during the post 12‐month period 13,16,17 and in the Song et al study it was only mentioned that it was recommended that patients be on lifelong aspirin, but the proportion of patients taking lifelong aspirin was not reported. Understanding what antiplatelet regime patients were treated with beyond 12 months may provide insight as to why the DAPT score may or may not be correlated to ischaemic and bleeding events.…”

Section: Discussionmentioning

confidence: 99%

“…Since the publication of the DAPT score several studies have been published evaluating it performance in predicting adverse events in several PCI populations and some report that it has modest predictive value, 12‐14 whereas others suggest that it is a poor predictor of adverse events 15,16 . To better understand the utility of the DAPT score as a risk stratification tool, we conducted a systematic review of the literature.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review of the studies that evaluate the performance of the DAPT score

Kwok

Wong

Nagaraja

et al. 2020

Int. J. Clin. Pract.

View full text Add to dashboard Cite

Background The Dual Antiplatelet Therapy (DAPT) score was derived to determine which patients may benefit from prolonged DAPT therapy after 12 months based on the balance between ischaemic and bleeding events. Several studies have attempted to validate the score with inconsistent findings. Methods We conducted a systematic review of the studies that evaluated the DAPT score in PCI populations. A search was performed on MEDLINE and EMBASE and two independent reviewers reviewed the search results for study inclusion and extracted data from studies which met the inclusion criteria. Data are presented in tables and narrative synthesis was performed. Results A total of 13 studies were included in this review. The study designs included post hoc analysis of randomised trials, prospective cohorts, retrospective cohorts and a case‐control study. In the derivation/validation study, the c‐statistic for ischaemic and bleeding outcomes were 0.64/0.70 and 0.68/0.64, respectively. Among the validation studies, the C‐statistics for composite outcomes ranged from 0.53 to 0.71 for ischaemic outcomes and 0.49 to 0.71 for bleeding outcomes. Only one study randomised patients with high DAPT score to different combinations of antiplatelet after 1 year of DAPT and found that continuation of DAPT was associated with fewer deaths because of myocardial infarction, but more bleeding. Conclusions While not designed for this purpose many studies have shown that the DAPT score has modest predictive value for ischaemic and bleeding outcomes. A prospective randomised controlled trial is needed to evaluate the clinical benefits of utilising the DAPT score in guiding continued DAPT therapy beyond 1 year.

show abstract

“…Overall, nine studies were included in our random-effect meta-analysis. 2,[6][7][8][9][10][11][12][13] Their characteristics are summarized in ►Supplementary Table S1 (available in the online version). Of the 100,211 patients included (►Supplementary Table S2, available in the online version), 42.5% had a DS 2 and when compared with those with lower DS, they experienced a significantly higher hazard of MI and ST combined (RR: 1.72; 95% CI: 1.50-1.97; p < 0.0001) and a significantly lower hazard of bleeding (RR: 0.79; 95% CI: 0.70-0.89; p ¼ 0.0001; ►Fig.…”

mentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

show abstract

External Validation of the DAPT Score in a Nationwide Population

Cited by 67 publications

References 25 publications

Long-Term Safety and Efficacy of Extended Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Real-World Practice

Long-Term Safety and Efficacy of Extended Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Real-World Practice

A systematic review of the studies that evaluate the performance of the DAPT score

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

Contact Info

Product

Resources

About