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The PRECISE-DAPT score and five-year outcomes after percutaneous coronary intervention: a large-scale, real-world study from China

Eur Heart J Qual Care Clin Outcomes. 2021 Sep 24:qcab068. doi: 10.1093/ehjqcco/qcab068. Online ahead of print.

ABSTRACT

AIMS: The PRECISE-DAPT score is recommended by guidelines for predicting out-of-hospital bleeding in patients after percutaneous coronary intervention (PCI). However, the long-term prognostic value of the PRECISE-DAPT score in patients after PCI remains unclear.

METHODS AND RESULTS: We performed a prospective study of 10,724 patients who underwent PCI throughout 2013 in Fuwai hospital. The bleeding endpoint was Bleeding Academic Research Consortium 2, 3, or 5 bleeding. The ischaemic endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). After a 5-year follow-up, 10,109 patients were finally analysed. A total of 415 (4.11%) patients experienced bleeding, 364 (3.60%) experienced all-cause death, and 2049 (20.27%) had MACCE. Using Cox regression, the risk of bleeding (hazard ratio [HR]: 1.721, 95% confidence interval [CI]: 1.180-2.511, P = 0.005), MACCE (HR: 1.607, 95% CI: 1.347-1.917, P < 0.001), and all-cause-death (HR: 3.902, 95% CI: 2.916-5.221, P < 0.001) in patients with a high score were significantly higher than those in patients with a low score. The PRECISE-DAPT score showed prognostic value for 5-year events of bleeding (C statistic: 0.566, 95% CI: 0.537-0.594), MACCE (C statistic: 0.540, 95% CI: 0.527-0.553), and all-cause-death (C statistic: 0.673, 95% CI: 0.644-0.702).

CONCLUSION: After 5 years of follow-up, the PRECISE-DAPT score has a statistically significant predictive value for long-term bleeding events in Chinese PCI population, and also had some prognostic value for death and MACCE.

PMID:34558620 | DOI:10.1093/ehjqcco/qcab068

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