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Long-term bleeding risk prediction with dual antiplatelet therapy after acute coronary syndromes treated without revascularization

Circulation: Cardiovascular Quality and Outcomes Sep 28, 2020

Marquis-Gravel G, Neely ML, Valgimigli M, et al. - Researchers assessed as well as compared the PRECISE-DAPT, PARIS, and DAPT (bleeding component) bleeding risk scores with respect to their performances in the medically managed patients with acute coronary syndrome (ACS) who received dual antiplatelet therapy (DAPT). These scores were applied in the TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) population. For the PRECISE-DAPT, PARIS, and DAPT (bleeding component) scores, the reported c-indices through 12 months were 0.716, 0.693, and 0.674, respectively, for GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) bleeding and 0.624, 0.612, and 0.608, respectively, for TIMI (Thrombolysis in Myocardial Infarction) bleeding. Findings showed that reasonable performances were displayed by the PRECISE-DAPT, PARIS, and DAPT (bleeding component) scores in medically managed patients with ACS treated with DAPT, and the performances of these scores were identified to be similar to their performances in the derivation percutaneous coronary intervention populations. Findings are suggestive of the likely usefulness of bleeding risk scores in predicting longitudinal bleeding risk in patients with ACS managed with DAPT without revascularization as well as in assisting support shared decision making.

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