Patient selection: coronary stent placement during PCI
DAPT: thienopyridine and aspirin
Outcome: bleeding, ischemic event
Parameters:
(1) age in years
(2) current cigarette smoker
(3) diabetes mellitus
(4) myocardial infarction at presentation
(5) history of PCI and/or AMI
(6) paclitaxel-eluting stent
(7) stent diameter in mm
(8) CHF or LVEF < 30%
(9) vein graft PCI
|
Parameter
|
Finding
|
Points
|
|
age in years
|
< 65 years
|
0
|
|
|
65 to 74.99 years
|
-1
|
|
|
>= 75 years
|
-2
|
|
current cigarette smoker
|
no
|
0
|
|
|
yes
|
1
|
|
diabetes mellitus
|
no
|
0
|
|
|
yes
|
1
|
|
AMI at presentation
|
no
|
0
|
|
|
yes
|
1
|
|
history of PCI or AMI
|
no
|
0
|
|
|
yes
|
1
|
|
paclitaxel-eluting stent
|
no
|
0
|
|
|
yes
|
1
|
|
stent diameter
|
< 3 mm
|
1
|
|
|
>= 3 mm
|
0
|
|
CHF or LVEF < 30%
|
no
|
0
|
|
|
yes
|
2
|
|
vein graft PCI
|
no
|
0
|
|
|
yes
|
2
|
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: -2
• maximum score: 10
• A score < 2 is associated with greater risk of bleeding with a similar risk for ischemia.
• A score >= 2 is associated with greater ischemic benefit (lower AMI or stent thrombosis).
• A patient with a high DAPT score may benefit from prolonged thienopyridine.
