Song Li, Guan Changdong, Yan Hongbing, Qiao Shubin, Wu Yongjian, Yuan Jinqing, Dou Kefei, Yang Yuejin, Dangas George D, Xu Bo
Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Department of Cardiology, Mount Sinai Medical Center, New York, New York.
Catheter Cardiovasc Interv. 2018 Feb 15;91(S1):573-581. doi: 10.1002/ccd.27468. Epub 2018 Jan 11.
We aimed to assess the prognostic ability of the ST score, DAPT score, and PARIS score in a Chinese population.
Recently, several risk scores predicting the long-term risk of coronary thrombotic events [CTE, defined as the composite of definite or probable stent thrombosis (ST) and myocardial infarction] and bleeding have been developed and initially validated in Western populations.
A total of 6,088 consecutive patients with acute coronary syndrome (mean age 58.3 ± 10.4; women 23.1%) treated with drug-eluting stents in 2013 at our single institution were enrolled. We calculated risk scores and evaluated their performance for predicting definite or probable ST, CTE and major bleeding (MB, defined as the occurrence of a Bleeding Academic Research Consortium type 3 or 5 bleed). The prognostic value of risk scores was assessed by receiver-operating characteristic curves.
The ST score, DAPT score, and PARIS score all showed unsatisfactory discrimination to predict 2-year or 1- to 2-year ST and CTE (c-statistic = 0.51-0.59). With respect to bleeding outcomes, the PARIS score showed unsatisfactory discrimination in predicting 2-year MB (c-statistic = 0.56); the DAPT score performed slightly better than the PARIS score in predicting occurrence of later MB events between 1 and 2 years, whereas its discriminative capacity was only modest (c-statistic = 0.71).
The current three risk scores, derived and initially validated in Western populations, may not be applicable to the Chinese population, although DAPT score was determined to be a modestly accurate quantitative tool for prediction of later MB.
我们旨在评估ST评分、双联抗血小板治疗（DAPT）评分和PARIS评分在中国人群中的预后预测能力。
最近，已开发出几种预测冠状动脉血栓形成事件[CTE，定义为明确或可能的支架血栓形成（ST）和心肌梗死的综合指标]和出血长期风险的风险评分，并在西方人群中进行了初步验证。
纳入2013年在我们单一机构接受药物洗脱支架治疗的6088例连续急性冠状动脉综合征患者（平均年龄58.3±10.4岁；女性占23.1%）。我们计算了风险评分，并评估了它们预测明确或可能的ST、CTE和大出血（MB，定义为发生出血学术研究联盟3型或5型出血）的性能。通过受试者操作特征曲线评估风险评分的预后价值。
ST评分、DAPT评分和PARIS评分在预测2年或1至2年的ST和CTE方面均表现出不理想的区分能力（c统计量=0.51-0.59）。关于出血结局，PARIS评分在预测2年MB方面表现出不理想的区分能力（c统计量=0.56）；DAPT评分在预测1至2年后期MB事件的发生方面比PARIS评分略好，但其区分能力仅为中等（c统计量=0.71）。
目前这三种在西方人群中得出并初步验证的风险评分可能不适用于中国人群，尽管DAPT评分被确定为预测后期MB的适度准确的定量工具。
