The Predictive Value of PRECISE-DAPT Score for In-Hospital Mortality in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Angiology. 2019 May;70(5):440-447. doi: 10.1177/0003319718807057. Epub 2018 Oct 15.

Abstract

The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy (PRECISE-DAPT) score predicts the bleeding risk in patients treated with dual antiplatelet treatment after primary percutaneous coronary intervention (pPCI). This study aimed to determine the predictive value of the admission PRECISE-DAPT score for in-hospital mortality in patients with ST elevation myocardial infarction (STEMI) treated with pPCI. Of the 1418 patients enrolled, the study population was divided into 2 groups: PRECISE-DAPT score ≥25 and PRECISE-DAPT score <25. The primary goal was to determine the incidence of in-hospital all-cause mortality. In-hospital mortality was significantly higher in patients whose PRECISE-DAPT score ≥25 compared with the patients whose PRECISE-DAPT score <25 (9.4 vs 0.9%; P < .001, respectively). Both univariate and multivariate Cox proportional hazard analyses showed that the PRECISE-DAPT score is independently associated with in-hospital mortality (hazards ratio [HR]: 1.043, 95% confidence interval [CI]: 1.003-1.084; P = .035; and HR: 1.026, 95% CI: 1.004-1.048; P = .021, respectively). A pairwise comparison of receiver operating characteristic curves showed that the predictive value of the PRECISE-DAPT score with regard to in-hospital mortality was noninferior compared with the Thrombolysis in Myocardial Infarction risk score. The PRECISE-DAPT score may be a significant independent predictor of in-hospital mortality in patients with STEMI treated with pPCI.

Keywords: PRECISE-DAPT score; ST elevation myocardial infarction; in-hospital mortality.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Decision Support Techniques*
  • Drug Therapy, Combination
  • Female
  • Hemorrhage / chemically induced
  • Hemorrhage / mortality
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / mortality*
  • Platelet Aggregation Inhibitors / administration & dosage*
  • Platelet Aggregation Inhibitors / adverse effects
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • ST Elevation Myocardial Infarction / diagnosis
  • ST Elevation Myocardial Infarction / mortality*
  • ST Elevation Myocardial Infarction / surgery*
  • Time Factors
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors