Tool predicts risks of DAPT with ‘modest accuracy’

Results in PROTECT cohort

In the PROTECT cohort, ischemia occurred in 79 patients (1.0%) and bleeding in 37 patients (0.5%). Again, the models predicting ischemia and bleeding had moderate discrimination, with c statistics of 0.64 for both outcomes.

The rate of ischemia from 12 through 30 months after PCI was greater among the high-score patients (n=2848) than the low-score patients (n=5288). The rates were 1.5% and 0.7%, respectively. The hazard ratio was 2.01 (P=0.002).

Rates of moderate or severe bleeding were not significantly different by DAPT Score. The rates were 0.4% in the high-score patients and 0.5% in the low-score patients. The hazard ratio was 0.69 (P=0.31).

The researchers said that, based on these results, use of the DAPT Score should be cautious pending further validation.

“We haven’t prospectively validated the use of the score, and it’s only applicable to patients similar to those who were randomized in the DAPT study, so we still need to be cautious,” Dr Yeh said. “Nevertheless, we think it represents a significant step forward in understanding benefits and risks of treatment.”