Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct 30:2024:1489008.
doi: 10.1155/2024/1489008. eCollection 2024.

Assessing the Utility of the DAPT Score and PRECISE-DAPT Score in Determining the Appropriateness of Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction/Percutaneous Coronary Intervention

Abhishek Singh  1 , M A Hussain  2 , Shyam Chand Chaudhary  2 , Akriti Bharadwaj  2 , K K Sawalani  2 , Akshyaya Pradhan  1 , Rishi Sethi  1
Affiliations

Assessing the Utility of the DAPT Score and PRECISE-DAPT Score in Determining the Appropriateness of Dual Antiplatelet Therapy in Patients With Acute Myocardial Infarction/Percutaneous Coronary Intervention

Abhishek Singh et al. Cardiol Res Pract. .

Abstract

Background: Utilizing the two available prediction models, i.e., the dual antiplatelet therapy (DAPT) score and predicting bleeding complication in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score, we aimed to determine the appropriateness of the DAPT in patients with acute myocardial infarction (AMI) in patients undergoing percutaneous coronary intervention (PCI). Methods: We retrospectively enrolled 235 patients of AMI and for all the patients and thorough information regarding history, risk factors, and medications were collected. Both DAPT and PRECISE-DAPT scores were calculated. The patients were divided by their recommended cutoffs and the appropriateness of the duration of the recommended DAPT was measured based on the observed scores. Bleeding academic research consortium (BARC) classification was used to define the bleeding events. In the patients with DAPT score ≥ 2 and PRESICE-DAPT < 25, the prolonged use of DAPT was recommended. Results: Overall, 235 patients, predominantly male (78.7%), with baseline characteristics exhibiting high rate of smoking (31.1%), diabetes (35.3%), and hypertension (32.8%) were found. The widely prescribed DAPT combination was aspirin with clopidogrel (72.3% at discharge and 46% on current use). Among all the enrolled patients, 163 patients were on DAPT while 71 were on single antiplatelet therapy (SAPT). A significant association between DAPT and PRECISE-DAPT scores was noted in terms of SAPT and DAPT. The appropriateness of DAPT was checked based on the scores, where 81% of the patients with DAPT ≥ 2 and 77.24% with PRECISE-DAPT score < 25 were appropriately prescribed with DAPT. The primary reason for drug interruptions was self-advised. The incidence of bleeding events was observed to be 7.23%, among which 5.1% had Type 1 bleeding according to BARC. Conclusion: Both DAPT and PRECISE-DAPT scores could be used to determine the appropriateness of the recommendations of DAPT in patients with AMI or undergoing PCI.

Keywords: ST elevation myocardial infarction; dual-antiplatelet therapy; hemorrhage; myocardial infarction.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of antiplatelet drugs used in the study groups.
Figure 2
Figure 2
The distribution of cases according to variables used in risk scores. CHF, congestive heart failure; LVEF, left ventricular ejection fraction; MI, myocardial infarction; PCI, percutaneous coronary intervention; PVD, peripheral vascular disease.
Figure 3
Figure 3
Appropriateness of antiplatelet therapy according to DAPT and PRECISE DAPT scores.
Figure 4
Figure 4
Representation of drug interruption reasons.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Yamamoto T., Yoshida N., Takayama M., Network T. C. Temporal Trends in Acute Myocardial Infarction Incidence and Mortality Between 2006 and 2016 in Tokyo―Report From the Tokyo CCU Network. Circulation Journal . 2019;83(6):1405–1409. - PubMed
    1. Piironen M., Ukkola O., Huikuri H, et al. Trends in Long-Term Prognosis After Acute Coronary Syndrome. European Journal of Preventive Cardiology . 2017;24(3):274–280. doi: 10.1177/2047487316679522. - DOI - PubMed
    1. Hariri E., Lessard D., Gore J., Rade J., Goldberg R. Are We Optimizing the Use of Dual Antiplatelet Therapy in Patients Hospitalized With Acute Myocardial Infarction? Cardiovascular Revascularization Medicine . 2020;21(2):182–188. - PMC - PubMed
    1. Lu Y. Y., Wang C. L., Chang S. H, et al. Dual Versus Single Antiplatelet Therapy in Medically Treated Acute Myocardial Infarction Patients With Baseline Thrombocytopenia—Insights From a Multi-Institute Cohort Study. Acta Cardiologica Sinica . 2022;38(4):443–454. doi: 10.6515/ACS.202207_38(4).20220109A. - DOI - PMC - PubMed
    1. Capodanno D., Alfonso F., Levine G. N., Valgimigli M., Angiolillo D. J. ACC/AHA Versus ESC Guidelines on Dual Antiplatelet Therapy: JACC Guideline Comparison. Journal of the American College of Cardiology . 2018;72(23 Part A):2915–2931. - PubMed

LinkOut - more resources