Comparative external validation of the PRECISE-DAPT and PARIS risk scores in 4424 acute coronary syndrome patients treated with prasugrel or ticagrelor.
- Bianco M Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy. Electronic address: matteo.bianco87@gmail.com.
- D'ascenzo F University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Raposeiras Roubin S Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Kinnaird T Cardiology Department, University Hospital of Wales, Cardiff, United Kingdom.
- Peyracchia M University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Ariza-Solé A Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain.
- Cerrato E Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy.
- Manzano-Fernández S Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain.
- Gravinese C Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy.
- Templin C Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland.
- Destefanis P Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy.
- Velicki L Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia.
- Luciano A Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy.
- Xanthopoulou I University Patras Hospital, Athens, Greece.
- Rinaldi M University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiac Surgery, Turin, Italy.
- Rognoni A Catheterization Laboratory, Maggiore della Carità Hospital, Novara, Italy.
- Varbella F Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy.
- Boccuzzi G Department of Cardiology, S.G. Bosco Hospital, Torino, Italy.
- Omedè P University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Montabone A Department of Cardiology, S.G. Bosco Hospital, Torino, Italy.
- Bernardi A University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Taha S Department of Cardiology, Faculty of Medicine, Assiut University, Egypt.
- Rossini R Division of Cardiology, A.O Santa Croce e Carle, Cuneo, Italy.
- Durante A U.O. Cardiologia, Ospedale Valduce, Como, Italy.
- Gili S Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland.
- Magnani G Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland.
- Autelli M University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Grosso A University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Blanco PF Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain.
- Giustetto C University of Turin, Città della Salute e della Scienza di Torino, Division of Cardiology, Turin, Italy.
- Garay A Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain.
- Quadri G Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano and Infermi Hospital, Rivoli, Turin, Italy.
- Queija BC Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Srdanovic I Medical Faculty, University of Novi Sad, Novi Sad, Serbia; Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia.
- Paz RC Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Fernández MC Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Pousa IM Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Gallo D PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy.
- Morbiducci U PolitoBIOMed Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Italy.
- Dominguez-Rodriguez A Department of Cardiology, University Hospital from Canarias, Tenerife, Spain.
- Lopez-Cuenca Á Department of Cardiology, University Hospital Virgen Arrtixaca, Murcia, Spain.
- Cequier A Department of Cardiology, University Hospital de Bellvitge, Barcelona, Spain.
- Alexopoulos D University Patras Hospital, Athens, Greece.
- Iñiguez-Romo A Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Pozzi R Division of Cardiology, San Luigi Gonzaga University Hospital, Orbassano, Italy.
- Assi EA Department of Cardiology, Hospital Álvaro Cunqueiro, Vigo, Pontevedra, Spain.
- Valgimigli M Swiss Cardiovascular Center Bern, Bern University Hospital, Switzerland.
- 2019-12-02
Published in:
- International journal of cardiology. - 2020
English
BACKGROUND
The PRECISE-DAPT and PARIS risk scores (RSs) were recently developed to help clinicians at individualizing the optimal dual antiplatelet therapy duration (DAPT) after percutaneous coronary intervention (PCI). Nevertheless, external validation of these RSs it has not yet been performed in ACS (acute coronary syndrome) patients treated with prasugrel or ticagrelor in a real- world scenario.
METHODS
4424 ACS patients who underwent PCI and survived to hospital discharge, from January 2012 to December 2016 at 12 European centers, were included. PRECISE-DAPT and PARIS bleeding RS, as well as PARIS ischemic RS, were computed, and their performance at predicting major bleeding (MB; BARC type 3 or 5) and ischemic events (MI and stent thrombosis) during follow up was compared.
RESULTS
After a median follow-up of 14 (interquartile range 12-20.9) months, 83 (1.88%) patients developed MB and 133 (3.0%) suffered an ischemic episode. PRECISE-DAPT performed better than PARIS bleeding RS (c-statistic = 0.653 vs. 0.593; p = .01 for comparison) in predicting MB. The RSs performance for MB prediction remained consistent in STEMI patients (c-statistic = 0.632 vs 0.575) or in those treated with prasugrel (c-statistic = 0.623 vs 0.586). PARIS ischemic RS exhibited superior discrimination in predicting ischemic complications compared to PRECISE-DAPT (c-statistic = 0.604 vs 0.568 p = .05 for comparison).
CONCLUSION
Our data provide support to the use of PRECISE-DAPT in MB risk stratification for patients receiving DAPT in form of aspirin and prasugrel or ticagrelor whereas the PARIS ischemic RS has potential to complement the risk prediction with respect to ischemic events.
The PRECISE-DAPT and PARIS risk scores (RSs) were recently developed to help clinicians at individualizing the optimal dual antiplatelet therapy duration (DAPT) after percutaneous coronary intervention (PCI). Nevertheless, external validation of these RSs it has not yet been performed in ACS (acute coronary syndrome) patients treated with prasugrel or ticagrelor in a real- world scenario.
METHODS
4424 ACS patients who underwent PCI and survived to hospital discharge, from January 2012 to December 2016 at 12 European centers, were included. PRECISE-DAPT and PARIS bleeding RS, as well as PARIS ischemic RS, were computed, and their performance at predicting major bleeding (MB; BARC type 3 or 5) and ischemic events (MI and stent thrombosis) during follow up was compared.
RESULTS
After a median follow-up of 14 (interquartile range 12-20.9) months, 83 (1.88%) patients developed MB and 133 (3.0%) suffered an ischemic episode. PRECISE-DAPT performed better than PARIS bleeding RS (c-statistic = 0.653 vs. 0.593; p = .01 for comparison) in predicting MB. The RSs performance for MB prediction remained consistent in STEMI patients (c-statistic = 0.632 vs 0.575) or in those treated with prasugrel (c-statistic = 0.623 vs 0.586). PARIS ischemic RS exhibited superior discrimination in predicting ischemic complications compared to PRECISE-DAPT (c-statistic = 0.604 vs 0.568 p = .05 for comparison).
CONCLUSION
Our data provide support to the use of PRECISE-DAPT in MB risk stratification for patients receiving DAPT in form of aspirin and prasugrel or ticagrelor whereas the PARIS ischemic RS has potential to complement the risk prediction with respect to ischemic events.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1016/j.ijcard.2019.11.132
- PMID 31785951
- Persistent URL
- https://folia.unifr.ch/global/documents/233303
Statistics
Document views: 27
File downloads:
- fulltext.pdf: 0