Ando Takuya, Nakazato Kazuhiko, Kimishima Yusuke, Kiko Takatoyo, Shimizu Takeshi, Misaka Tomofumi, Yamada Shinya, Kaneshiro Takashi, Yoshihisa Akiomi, Yamaki Takayoshi, Kunii Hiroyuki, Takeishi Yasuchika
Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan.
Int J Cardiol Heart Vasc. 2020 Jun 7;29:100552. doi: 10.1016/j.ijcha.2020.100552. eCollection 2020 Aug.
The predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score predicts the risk of bleeding in patients treated with dual antiplatelet therapy after percutaneous coronary intervention. Although the PRECISE-DAPT score is expected to be useful beyond its original field, long-term prognostic value of this score in patients with acute myocardial infarction (AMI) remains unclear. In the current study, we aimed to investigate the performance of the PRECISE-DAPT score in predicting the long-term prognosis in patients with AMI.
Consecutive 552 patients with AMI, who had been discharged from our institution, were enrolled. We divided the patients into three groups, based on their PRECISE-DAPT scores: the low (PRECISE-DAPT < 17), intermediate (17-24) and high (≥25) score groups. Kaplan-Meier analysis (mean follow-up 1424 days) revealed that all-cause mortality increased most steeply in the high score group followed by the intermediate and low score groups (P < 0.001). After adjusting for possible confounding factors, mortality of the intermediate or high score groups were higher than those of low score group (HR 2.945, 95% CI 1.182-7.237, P = 0.020, and HR 5.567, 95% CI 2.644-11.721, P < 0.001, respectively).
In patients with AMI, a high PRECISE-DAPT score was associated with higher long-term all-cause mortality. PRECISE-DAPT score is useful for predicting all-cause mortality, as well as risk stratification of bleeding.
支架植入及后续双联抗血小板治疗患者出血并发症预测(PRECISE-DAPT)评分可预测经皮冠状动脉介入治疗后接受双联抗血小板治疗患者的出血风险。尽管预计PRECISE-DAPT评分在其原始领域之外也有用,但该评分在急性心肌梗死(AMI)患者中的长期预后价值仍不明确。在本研究中,我们旨在探讨PRECISE-DAPT评分在预测AMI患者长期预后方面的性能。
纳入了我院连续出院的552例AMI患者。我们根据患者的PRECISE-DAPT评分将其分为三组:低评分组(PRECISE-DAPT<17)、中评分组(17-24)和高评分组(≥25)。Kaplan-Meier分析(平均随访1424天)显示,全因死亡率在高评分组中上升最为陡峭,其次是中评分组和低评分组(P<0.001)。在调整可能的混杂因素后,中评分组或高评分组的死亡率高于低评分组(HR分别为2.945,95%CI为1.182-7.237,P = 0.020;HR为5.567,95%CI为2.644-11.721,P<0.001)。
在AMI患者中,高PRECISE-DAPT评分与较高的长期全因死亡率相关。PRECISE-DAPT评分不仅有助于预测全因死亡率,还可用于出血风险分层。