Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients
BackgroundRecently, the Age–Bleeding–Organ Dysfunction (ABO) algorithm was recommended by the Asian Pacific Society of Cardiology Consensus as a binary approach to evaluate bleeding risk. This analysis made comparison of the predictive performances between the PRECISE-DAPT and ABO bleeding score in...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.910805/full |
| _version_ | 1811325618983272448 |
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| author | Liang Dong Cao Lu Chen Wensen Chen Fuzhong Muhammad Khalid Dong Xiaoyu Li Guangjuan Qian Yanxia Zhang Yufeng Liu Xinjian Chen Leilei Wang Junhong Wang Junhong |
| author_facet | Liang Dong Cao Lu Chen Wensen Chen Fuzhong Muhammad Khalid Dong Xiaoyu Li Guangjuan Qian Yanxia Zhang Yufeng Liu Xinjian Chen Leilei Wang Junhong Wang Junhong |
| author_sort | Liang Dong |
| collection | DOAJ |
| description | BackgroundRecently, the Age–Bleeding–Organ Dysfunction (ABO) algorithm was recommended by the Asian Pacific Society of Cardiology Consensus as a binary approach to evaluate bleeding risk. This analysis made comparison of the predictive performances between the PRECISE-DAPT and ABO bleeding score in identifying the risk of 12-months major bleeding in Chinese elderly patients over 65 years old patients who underwent percutaneous coronary intervention (PCI) during dual-antiplatelet therapy period.MethodsA total of 2,037 elderly coronary artery disease (CAD) patients (≥65 years) receiving dual antiplatelet therapy (DAPT) after PCI were enrolled in the study. The predictive accuracy of the two bleeding risk scores (PRECISE-DAPT and ABO) was compared for identifying the risk of bleeding during the dual-antiplatelet therapy in patients who underwent PCI. Major clinically relevant bleeding events were defined according to the Bleeding Academic Research Consortium (BARC) criteria.ResultsThe PRECISE-DAPT score in the no bleeding, BARC = 1 bleeding, BARC ≥ 2 bleeding patients was 23.55 ± 10.46, 23.23 ± 10.03, and 33.54 ± 14.33 (p < 0.001), respectively. Meanwhile, the ABO score in the three groups was 0.72 ± 0.80, 0.69 ± 0.81, and 1.49 ± 0.99 (p < 0.001), respectively. The C-statistic of the PRECISE-DAPT model for prediction of BARC ≥ 2 bleeding in overall patients was 0.717 (95% CI, 0.656–0.777) and 0.720 (95% CI, 0.656–0.784) in acute coronary syndrome (ACS) patients. Similar discriminatory capacity was demonstrated in the ABO risk score [overall, patients, AUC: 0.712 (95% CI, 0.650–0.774); ACS patients, AUC: 0.703 (95% CI, 0.634–0.772)]. No differences were observed when the ABO model was in comparison with the PRECISE-DAPT model, regardless in overall patients (z = −0.199, p = 0.842) or ACS patients (z = −0.605, p = 0.545). The calibration for BARC ≥ 2 bleeding of the PRECISE-DAPT and ABO score were acceptable, regardless in overall patients [goodness-of-fit (GOF) Chi-square = 0.432 and 0.001, respectively; p-value = 0.806 and 0.999, respectively] or ACS patients (GOF Chi-square = 0.008 and 0.580, respectively; p-value = 0.996 and 0.748, respectively).ConclusionNo matter of clinical presentation in Asian 65-years older patients with DAPT, the PRECISE-DAPT, and ABO scores had the similar discriminative ability for 12-months BARC ≥ 2 bleeding. Considering the simplicity and reliability, the PRECISE-DAPT score might be more clinically applicable in the overall population and ACS patients in bleeding prediction. |
| first_indexed | 2024-04-13T14:36:25Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-13T14:36:25Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-d6088edd953d44759e3ea16233abae4b2022-12-22T02:43:01ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-07-01910.3389/fcvm.2022.910805910805Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly PatientsLiang Dong0Cao Lu1Chen Wensen2Chen Fuzhong3Muhammad Khalid4Dong Xiaoyu5Li Guangjuan6Qian Yanxia7Zhang Yufeng8Liu Xinjian9Chen Leilei10Wang Junhong11Wang Junhong12Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaOffice of Infection Management, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, Xinjiang Yili Friendship Hospital, Yili Kazak Autonomous Prefecture, Xinjiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, Xinjiang Yili Friendship Hospital, Yili Kazak Autonomous Prefecture, Xinjiang, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Cardiology, Xinjiang Yili Friendship Hospital, Yili Kazak Autonomous Prefecture, Xinjiang, ChinaBackgroundRecently, the Age–Bleeding–Organ Dysfunction (ABO) algorithm was recommended by the Asian Pacific Society of Cardiology Consensus as a binary approach to evaluate bleeding risk. This analysis made comparison of the predictive performances between the PRECISE-DAPT and ABO bleeding score in identifying the risk of 12-months major bleeding in Chinese elderly patients over 65 years old patients who underwent percutaneous coronary intervention (PCI) during dual-antiplatelet therapy period.MethodsA total of 2,037 elderly coronary artery disease (CAD) patients (≥65 years) receiving dual antiplatelet therapy (DAPT) after PCI were enrolled in the study. The predictive accuracy of the two bleeding risk scores (PRECISE-DAPT and ABO) was compared for identifying the risk of bleeding during the dual-antiplatelet therapy in patients who underwent PCI. Major clinically relevant bleeding events were defined according to the Bleeding Academic Research Consortium (BARC) criteria.ResultsThe PRECISE-DAPT score in the no bleeding, BARC = 1 bleeding, BARC ≥ 2 bleeding patients was 23.55 ± 10.46, 23.23 ± 10.03, and 33.54 ± 14.33 (p < 0.001), respectively. Meanwhile, the ABO score in the three groups was 0.72 ± 0.80, 0.69 ± 0.81, and 1.49 ± 0.99 (p < 0.001), respectively. The C-statistic of the PRECISE-DAPT model for prediction of BARC ≥ 2 bleeding in overall patients was 0.717 (95% CI, 0.656–0.777) and 0.720 (95% CI, 0.656–0.784) in acute coronary syndrome (ACS) patients. Similar discriminatory capacity was demonstrated in the ABO risk score [overall, patients, AUC: 0.712 (95% CI, 0.650–0.774); ACS patients, AUC: 0.703 (95% CI, 0.634–0.772)]. No differences were observed when the ABO model was in comparison with the PRECISE-DAPT model, regardless in overall patients (z = −0.199, p = 0.842) or ACS patients (z = −0.605, p = 0.545). The calibration for BARC ≥ 2 bleeding of the PRECISE-DAPT and ABO score were acceptable, regardless in overall patients [goodness-of-fit (GOF) Chi-square = 0.432 and 0.001, respectively; p-value = 0.806 and 0.999, respectively] or ACS patients (GOF Chi-square = 0.008 and 0.580, respectively; p-value = 0.996 and 0.748, respectively).ConclusionNo matter of clinical presentation in Asian 65-years older patients with DAPT, the PRECISE-DAPT, and ABO scores had the similar discriminative ability for 12-months BARC ≥ 2 bleeding. Considering the simplicity and reliability, the PRECISE-DAPT score might be more clinically applicable in the overall population and ACS patients in bleeding prediction.https://www.frontiersin.org/articles/10.3389/fcvm.2022.910805/fullbleeding risk scorespercutaneous coronary interventiondual-antiplatelet therapyPRECISE-DAPTABO score |
| spellingShingle | Liang Dong Cao Lu Chen Wensen Chen Fuzhong Muhammad Khalid Dong Xiaoyu Li Guangjuan Qian Yanxia Zhang Yufeng Liu Xinjian Chen Leilei Wang Junhong Wang Junhong Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients Frontiers in Cardiovascular Medicine bleeding risk scores percutaneous coronary intervention dual-antiplatelet therapy PRECISE-DAPT ABO score |
| title | Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients |
| title_full | Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients |
| title_fullStr | Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients |
| title_full_unstemmed | Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients |
| title_short | Performance of PRECISE-DAPT and Age–Bleeding–Organ Dysfunction Score for Predicting Bleeding Complication During Dual Antiplatelet Therapy in Chinese Elderly Patients |
| title_sort | performance of precise dapt and age bleeding organ dysfunction score for predicting bleeding complication during dual antiplatelet therapy in chinese elderly patients |
| topic | bleeding risk scores percutaneous coronary intervention dual-antiplatelet therapy PRECISE-DAPT ABO score |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.910805/full |
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