Affirming the utility of dual anti-platelet therapy score in patients from percutaneous coronary intervention studies


eMediNexus Editorial    24 February 2018

A study published in the Circulation journal assessed the utility of the dual anti-platelet therapy (DAPT) score in the Japanese population. The researchers suggested that this score was successful in stratifying ischemic and bleeding risks in this set of patients. The ischemic event rate was reported to be significantly low even in patients with a DAPT score ≥ 2 (high DS).

The pooled cohort of 3 studies conducted in Japan [the CREDO-Kyoto (Coronary Revascularization Demonstrating Outcome Study in Kyoto) Registry Cohort-2, RESET (Randomized Evaluation of Sirolimus-Eluting Versus Everolimus-Eluting Stent Trial), and NEXT (NOBORI Biolimus-Eluting Versus XIENCE/PROMUS Everolimus-Eluting Stent Trial)] was used to compare the risks for ischemic and bleeding events from 13 to 36 months after percutaneous coronary intervention (PCI) among patients with a DAPT score ≥ 2 (high DS) and a DAPT score < 2 (low DS). Among 12,223 patients who received drug-eluting stents and were free from ischemic or bleeding events at 13 months after PCI, 3,944 patients had high DS and 8,279 had low DS. The cumulative incidence of primary ischemic end point (myocardial infarction/stent thrombosis) was remarkably greater in high DS than in low DS (1.5% vs. 0.9%), while that of primary bleeding end point (GUSTO moderate/severe) tended to be lower in high DS than in low DS (2.1% vs. 2.7%). The cumulative incidences of cardiac death, myocardial infarction, and stent thrombosis were also significantly higher in high DS than in low DS (2% vs. 1.4%; 1.5% vs. 0.8%; 0.7% vs. 0.3%, respectively). On the other hand, the cumulative incidences of non-cardiac death and GUSTO severe bleeding were significantly lower in high DS than in low DS (2.4% vs. 3.9%; 1% vs. 1.6%, respectively).

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