External validity of the PRECISE-DAPT score in patients undergoing PCI: a systematic review and meta-analysis

被引:13
作者
Munafo, Andrea Raffaele [1 ,2 ]
Montalto, Claudio [2 ]
Franzino, Marco [3 ]
Pistelli, Lorenzo [3 ]
Di Bella, Gianluca [4 ]
Ferlini, Marco [5 ]
Leonardi, Sergio [1 ,5 ]
D'Ascenzo, Fabrizio [6 ]
Gragnano, Felice [7 ]
Oreglia, Jacopo A. [2 ]
Oliva, Fabrizio [2 ]
Ortega-Paz, Luis [8 ]
Calabro, Paolo [7 ]
Angiolillo, Dominick J. [8 ]
Valgimigli, Marco [9 ]
Micari, Antonio [3 ]
Costa, Francesco [3 ]
机构
[1] Univ Pavia, Dept Mol Med, I-27100 Pavia, Italy
[2] Osped Niguarda Ca Granda, De Gasperis Cardio Ctr, Intervent Cardiol Unit, I-20162 Milan, Italy
[3] Univ Messina, BIOMORF Dept, I-98125 Messina, Italy
[4] Univ Messina, Policlin G Martino, Dept Clin & Expt Med & Pharmacol, I-98124 Messina, Italy
[5] Fdn IRCCS Policlin San Matteo, Div Cardiol, I-27100 Pavia, Italy
[6] Citta Salute & Sci, Div Cardiol, Cardiovasc & Thorac Dept, I-10126 Turin, Italy
[7] Univ Campania Luigi Vanvitelli, Dept Translat Med Sci, Via Palasciano, I-81100 Caserta, Italy
[8] Univ Florida, Coll Med, Div Cardiol, 655 West 8th St, Jacksonville, FL 32209 USA
[9] Univ Svizzera Italiana, Ente Osped Cantonale EOC, Cardioctr Ticino Inst, Cardiovasc Dept, CH-6900 Lugano, Switzerland
关键词
Dual antiplatelet therapy; Percutaneous coronary intervention; Acute coronary syndrome; Bleeding risk; DUAL ANTIPLATELET THERAPY; ACUTE CORONARY SYNDROMES; ELDERLY-PATIENTS; RISK SCORES; VALIDATION; PREDICTION; CRITERIA; APPLICABILITY; MORTALITY;
D O I
10.1093/ehjcvp/pvad063
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims To summarize the totality of evidence validating the Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT) score, ascertaining its aggregate discrimination and validation power in multiple population subsets.Methods and results We searched electronic databases from 2017 (PRECISE-DAPT proposal) up to March 2023 for studies that reported the occurrence of out-of-hospital bleedings according to the PRECISE-DAPT score in patients receiving DAPT following percutaneous coronary intervention (PCI). Pooled odds ratios (OR) with 95% confidence interval (CI) were used as summary statistics and were calculated using a random-effects model. Primary and secondary endpoints were the occurrence of any and major bleeding, respectively. A total of 21 studies and 67 283 patients were included; 24.7% of patients (N = 16 603) were at high bleeding risk (PRECISE-DAPT score >= 25), and when compared to those at low bleeding risk, they experienced a significantly higher rate of any out-of-hospital bleeding (OR: 2.71; 95% CI: 2.24-3.29; P-value <0.001) and major bleedings (OR: 3.51; 95% CI: 2.71-4.55; P-value <0.001). Pooling data on c-stat whenever available, the PRECISE-DAPT score showed a moderate discriminative power in predicting major bleeding events at 1 year (pooled c-stat: 0.71; 95% CI: 0.64-0.77).Conclusion This systematic review and meta-analysis confirms the external validity of the PRECISE-DAPT score in predicting out-of-hospital bleeding outcomes in patients on DAPT following PCI. The moderate discriminative ability highlights the need for future improved risk prediction tools in the field.
引用
收藏
页码:709 / 721
页数:13
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