DAPT score: Difference between revisions

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==Interpretation==
==Interpretation==
* Score <2: Higher risk of bleeding and a smaller reduction in ischemia, associated with an unfavorable benefit-to-risk ratio for prolonged DAPT
* '''Score ≥2 (high score):''' <u>Favorable</u> benefit-to-risk for prolonged DAPT, with greater ischemic reduction (2.7% for DAPT vs 5.7% for aspirin alone; difference, −3.0% [95% CI, −4.1% to −2.0%]) and smaller bleeding increase (1.8% vs 1.4%; difference, 0.4% [95% CI, −0.3% to 1.0%])
* Score ≥2: Smaller risk of bleeding and a greater reduction in ischemia, associated with a favorable benefit-to-risk ratio for prolonged DAPT
* '''Score <2 (low score):''' <u>Unfavorable</u> benefit-to-risk for prolonged DAPT, with smaller ischemic reduction (1.7% for DAPT vs 2.3% for aspirin alone; difference, −0.7% [95% CI, −1.4% to 0.1%]) but greater bleeding increase (3.0% vs 1.4%; difference, 1.5% [95% CI, 0.8% to 2.3%])


==See also==
==See also==

Revision as of 02:42, 5 February 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]

Synonyms and keywords: Dual Antiplatelet Therapy score; DAPT (Dual Antiplatelet Therapy) score; DAPT score calculator; Dual Antiplatelet Therapy score calculator; DAPT (Dual Antiplatelet Therapy) score calculator

Overview

The DAPT score is a clinical prediction score assessing ischemic and bleeding risks at 12 to 30 months following percutaneous coronary intervention (PCI) to inform the duration of dual antiplatelet therapy (DAPT). The score was derived from the DAPT study (ClinicalTrials.gov: NCT00977938) and initially validated in the PROTECT trial (ClinicalTrials.gov: NCT00476957).

DAPT Score

The DAPT score is a simplified clinical prediction score designed to assess the benefit-risk tradeoff between ischemia reduction (myocardial infarction or stent thrombosis) and bleeding increase (moderate or severe hemorrhage) associated with continued thienopyridine plus aspirin versus aspirin alone beyond one year after PCI based on 11,648 patients enrolled in the DAPT study (derivation cohort) and 8,136 patients enrolled in the PROTECT trial (validation cohort).[1]

DAPT Score Calculator

Shown below is the calculator for the DAPT score (check all the boxes that apply):

DAPT Score Calculator
Variable Score
Age ≥ 75 years old -2
65-74 years old -1
< 65 years old 0
Cigarette smoking 1
Diabetes mellitus 1
Prior MI or PCI 1
MI at presentation 1
Paclitaxel-eluting stent 1
Stent diameter < 3 mm 1
CHF or LVEF < 30% 2
Vein graft stent 2
DAPT Score:
Interpretation:

Interpretation

  • Score ≥2 (high score): Favorable benefit-to-risk for prolonged DAPT, with greater ischemic reduction (2.7% for DAPT vs 5.7% for aspirin alone; difference, −3.0% [95% CI, −4.1% to −2.0%]) and smaller bleeding increase (1.8% vs 1.4%; difference, 0.4% [95% CI, −0.3% to 1.0%])
  • Score <2 (low score): Unfavorable benefit-to-risk for prolonged DAPT, with smaller ischemic reduction (1.7% for DAPT vs 2.3% for aspirin alone; difference, −0.7% [95% CI, −1.4% to 0.1%]) but greater bleeding increase (3.0% vs 1.4%; difference, 1.5% [95% CI, 0.8% to 2.3%])

See also

References

  1. Yeh, Robert W.; Secemsky, Eric A.; Kereiakes, Dean J.; Normand, Sharon-Lise T.; Gershlick, Anthony H.; Cohen, David J.; Spertus, John A.; Steg, Philippe Gabriel; Cutlip, Donald E.; Rinaldi, Michael J.; Camenzind, Edoardo; Wijns, William; Apruzzese, Patricia K.; Song, Yang; Massaro, Joseph M.; Mauri, Laura (2016). "Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention". JAMA. 315 (16): 1735. doi:10.1001/jama.2016.3775. ISSN 0098-7484.