Use of PRECISE-DAPT Score and Admission Platelet Count to Predict Mortality Risk in Patients With Acute Coronary Syndrome

被引：17

作者：

Morici, Nuccia ^{[1
,2
,3
]}

Tavecchia, Giovanni A. ^{[1
,2
]}

Antolini, Laura ^{[4
]}

Caporale, Maria R. ^{[1
,2
]}

Cantoni, Silvia ^{[5
]}

Bertuccio, Paola ^{[3
]}

Sacco, Alice ^{[1
,2
]}

Meani, Paolo ^{[1
,2
]}

Viola, Giovanna ^{[1
,2
]}

Brunelli, Dario ^{[1
,2
]}

Oliva, Fabrizio ^{[1
,2
]}

Lombardi, Federico ^{[6
]}

Segreto, Antonio ^{[7
]}

Oreglia, Jacopo A. ^{[1
,2
]}

La Vecchia, Carlo ^{[3
]}

Cattaneo, Marco ^{[8
,9
]}

Valgimigli, Marco ^{[10
]}

Savonitto, Stefano ^{[11
]}

机构：

[1] ASST Grande Osped Metropolitano Niguarda, Intens Cardiac Care Unit, Milan, Italy

[2] ASST Grande Osped Metropolitano Niguarda, Gasperis Cardio Ctr, Milan, Italy

[3] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy

[4] Univ Milano Bicocca, Ctr Biostat Clin Epidemiol, Sch Med, Monza, Italy

[5] ASST Grande Osped Metropolitano Niguarda, Hematol Dept, Milan, Italy

[6] Univ Milan, Fdn IRCCS Osped Maggiore Policlin, UOC Cardiol, Milan, Italy

[7] Univ Bari, Dipartimento Emergenza & Trapianto Organo, Bari, Italy

[8] Univ Milan, Hlth Sci Dept, Milan, Italy

[9] ASST Santi Paolo & Carlo, Unita Med 3, Milan, Italy

[10] Univ Hosp Bern, Dept Cardiol, Bern, Switzerland

[11] Osped Manzoni, Div Cardiol, Lecce, Italy

来源：

ANGIOLOGY | 2019年 / 70卷 / 09期

关键词：

thrombocytopenia; risk score; acute coronary syndrome; DUAL ANTIPLATELET THERAPY; BLOOD-CELL COUNT; ACUTE MYOCARDIAL-INFARCTION; DRUG-ELUTING STENTS; CKD-EPI EQUATION; CLINICAL-OUTCOMES; RENAL DYSFUNCTION; LEUKOCYTE COUNT; FOCUSED UPDATE; DISEASE;

D O I：

10.1177/0003319719848547

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Antiplatelet Therapy (PRECISE-DAPT) score has been validated to predict bleeding complications in patients undergoing stent implantation and dual antiplatelet therapy. This score does not include the platelet count (PC), which has been shown to be an independent marker of mortality in patients with acute coronary syndrome (ACS). We assessed the role of the PRECISE-DAPT score calculated on admission for mortality risk prediction and evaluated whether the predictive accuracy of this score improved by adding the PC. In a retrospective cohort study of 1000 patients with ACS, after adjustment for relevant covariates, a PRECISE-DAPT score >= 25 was independently associated with mortality (hazard ratio [HR]: 7.91; 95% confidence interval [CI]: 4.37-14.30). When this score was combined with PC, compared to patients with PRECISE-DAPT <25 and PC >= 150 x 10(9)/L, the adjusted HR was 7.2 (95% CI 2.4-21.6) for those with PRECISE-DAPT <25 and PC <150 x 10(9)/L; 10.7 (95% CI: 5.2-21.9) for those with PRECISE-DAPT >= 25 and PC >= 150 x 10(9)/L; and 17.9 (95% CI 7.0-45.4) for those with PRECISE-DAPT >= 25 and PC <150 x 10(9)/L. Selecting thresholds for high-risk designation, the PRECISE-DAPT score integrated with PC had a higher prediction value, compared to the PRECISE-DAPT and Global Registry of Acute Coronary Events scores.

引用

页码：867 / 877

页数：11

共 55 条

[1] 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: Executive Summary A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines [J].