Pelliccia Francesco, Gragnano Felice, Pasceri Vincenzo, Marazzi Giuseppe, Cacciotti Luca, Placanica Attilio, Niccoli Giampaolo, Palmerini Tullio, Speciale Giulio, Granatelli Antonino, Calabrò Paolo
Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
Division of Clinical Cardiology, A.O.R.N. 'Sant'Anna e San Sebastiano', Caserta, Italy.
Platelets. 2022 Nov 17;33(8):1228-1236. doi: 10.1080/09537104.2022.2102602. Epub 2022 Jul 25.
The risk of bleeding as predicted by the PRECISE-DAPT score can vary over time after percutaneous coronary intervention (PCI). We sought to compare the predictive ability of the PRECISE-DAPT score calculated at baseline and reassessed during follow-up in male and female patients undergoing PCI. The RE-SCORE was a multicenter, prospective registry including patients undergoing PCI treated with dual antiplatelet therapy (DAPT) for 1 year. The primary endpoint was Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding. The PRECISE-DAPT score was determined for each patient at the time of PCI and at 1, 4 and 8-month follow-up visits or before the occurrence of an endpoint event. A total of 480 patients undergoing PCI were included. At baseline, median PRECISE-DAPT score was similar in males (23.2 [IQR 20.1-24.2]) and females (23.4 [IQR 20.2-25.3]; p = .22). During follow-up, an increase in the PRECISE-DAPT occurred significantly more often in females (44%) than in males (23%; p < .001). The discrimination of the PRECISE-DAPT score calculated at baseline was marginal in both males (c-index = 0.59, 95% CI: 0.51-0.65) and females (c-index = 0.55, 95% CI: 0.49-0.60). The discriminative ability of the score reassessed at follow-up was excellent in females (c-index = 0.84; 95% CI: 0.77-0.91) but remained modest in males (c-index = 0.61; 95% CI: 0.55-0.70). The bleeding predictive ability of the PRECISE-DAPT score can vary over time, more commonly in females than males. The discrimination of the score calculated during follow-up appeared improved in females but remained modest in males. ClinicalTrials.gov Identifier: NCT03526614.
经皮冠状动脉介入治疗（PCI）后，PRECISE-DAPT评分预测的出血风险可能随时间变化。我们试图比较在接受PCI的男性和女性患者中，基线时计算的PRECISE-DAPT评分与随访期间重新评估的评分的预测能力。RE-SCORE是一项多中心前瞻性注册研究，纳入接受双重抗血小板治疗（DAPT）1年的PCI患者。主要终点是出血学术研究联盟（BARC）2、3或5型出血。在PCI时以及1、4和8个月随访时或终点事件发生前，为每位患者确定PRECISE-DAPT评分。共纳入480例接受PCI的患者。基线时，男性（23.2[四分位间距20.1-24.2]）和女性（23.4[四分位间距20.2-25.3]；p=0.22）的PRECISE-DAPT评分中位数相似。随访期间，女性（44%）PRECISE-DAPT评分升高的情况显著多于男性（23%；p<0.001）。基线时计算的PRECISE-DAPT评分在男性（c指数=0.59，95%CI：0.51-0.65）和女性（c指数=0.55，95%CI：0.49-0.60）中的辨别能力都很微弱。随访时重新评估的评分在女性中的辨别能力极佳（c指数=0.84；95%CI：0.77-0.91），但在男性中仍一般（c指数=0.61；95%CI：0.55-0.70）。PRECISE-DAPT评分的出血预测能力可能随时间变化，女性比男性更常见。随访期间计算的评分在女性中的辨别能力有所改善，但在男性中仍一般。临床试验注册号：NCT03526614。
