Document Type : Original Article

Authors

Cardiology Department, Faculty of Medicine, Assiut University, Egypt.

Abstract

Background: Recent guidelines recommend the use of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score for bleeding risk stratification and determining the appropriate duration of DAPT following primary percutaneous coronary intervention (PPCI). Our study aimed to assess the predictive value of the PRECISE-DAPT score for not only bleeding complications but also in-hospital and short-term complications, including major adverse cardiovascular events (MACEs) and no-reflow.
 
Methods: The study included 241 patients diagnosed with STEMI and eligible for PPCI. The patients were divided into 3 groups according to their PRECISE-DAPT score value: low (<17), intermediate (17–24), and high (≥25) score groups. Finally, in-hospital and short-term (180 d) follow-ups for MACEs, no-reflow, and bleeding complications were done.
 
Results: In-hospital and short-term complications were higher among the high-score group than in the other groups (P<0.001). The high-score group had lower thrombosis in myocardial infarction (TIMI flow<III) than the other groups, which was statistically significant (P= 0.001). The PRECISE-DAPT score had good predictive power for in-hospital complications (AUC=0.64) and short-term follow-up MACEs (AUC=0.80; P=0.004 and P<0.001, respectively), demonstrating good sensitivity and specificity of the PRECISE-DAPT score for the prediction of in-hospital complications, no-reflow, bleeding complications, and follow-up MACEs.
 
Conclusions: The PRECISE-DAPT score had a strong and independent predictive value for in-hospital, short-term MACEs, no-reflow, and bleeding complications among STEMI patients treated with PPCI. (Iranian Heart Journal 2024; 25(2): 35-46)

Keywords