PRECISE-DAPT Score of Costa et al for 1-Year Bleeding Risk on Dual Antiplatelet Therapy After Percutaneous Coronary Intervention (PCI) with Stent Placement
Costa et al identified patents at risk for bleeding after a percutaneous coronary intervention (PCI) with stent placement and dual antiplatelet therapy. The authors are from multiple institutions in Europe, South Korea, the United States and Brazil belonging to the PRECISE-DAPT Study Investigators.
Patient selection: PCI stent with dual antiplatelet therapy (usually aspirin plus a P2Y12 inhibitor)
Exclusion: long-term oral anticoagulation
Outcome: 1 year bleeding (excluding first 7 days after the procedure)
Parameters:
(1) hemoglobin in g/dL
(2) white blood cell count per µL
(3) age in years
(4) creatinine clearance in mL per minute
(5) history of previous bleed
Parameter
Finding
Points
hemoglobin
>= 12 g/dL
0
10 to 12 g/dL
88.8 - (7.4 * (hemoglobin)
<= 10 g/dL
15
white blood cell count
<=5,000
0
5,000 to 20,000
((WBC)/1000) - 5
>= 20,000
15
age in years
<= 50 years
0
50 to 90
(0.47 * (age)) - 23.57
>= 90 years
19
creatinine clearance
>= 100 mL/min
0
0 to 100
25.14 - (0.2445 * (creat))
0
25
history of previous bleed
no
0
yes
26
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 85
• The higher the score the greater the risk of bleeding within 1 year.
• The area under the ROC curve is 0.73 for out-of-hospital TIMI major and minor bleeding (derivation cohort), 0.70 (PLATO trial) and 0.66 (BERNPCI registry).
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