Hideyuki Kawashima1,2, Chao Gao2,3, Kuniaki Takahashi1, Mariusz Tomaniak4, Masafumi Ono1,2, Hironori Hara1, Rutao Wang2,3, Ply Chichareon5, Harry Suryapranata3, Simon Walsh6, James Cotton7, Rene Koning8, Benno Rensing9, Joanna Wykrzykowska1, Robbert J de Winter1, Scot Garg10, Richard Anderson11, Christian Hamm12, Philippe Gabriel Steg13,14, Yoshinobu Onuma2, Patrick W Serruys2,15. 1. Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Heart Center, Amsterdam, The Netherlands. 2. Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland. 3. Department of Cardiology, Radboudumc, Nijmegen, The Netherlands. 4. First Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. 5. Cardiology Unit, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. 6. Department of Cardiology, Belfast Health and Social Care Trust, Belfast, United Kingdom. 7. Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom. 8. Clinique Saint-Hilaire, Rouen, France. 9. Sint-Antonius Ziekenhuis, Nieuwegein, The Netherlands. 10. East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, United Kingdom. 11. Cardiff and Vale University Health Board, Wales, United Kingdom. 12. Kerckhoff Heart Center, Campus University of Giessen, Bad Nauheim, Germany. 13. Assistance Publique-Hôpitaux de Paris, INSERM U-1148, FACT (French Alliance for Cardiovascular Trials), Hôpital Bichat, Université de Paris, Paris, France. 14. Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, United Kingdom. 15. NHLI, Imperial College London, London, United Kingdom.
Abstract
BACKGROUND: The utility of the PRECISE-DAPT score in predicting short-term major bleeding, either alone, or in comparison with the CRUSADE and ACUITY scores, has not been investigated. This analysis compared the predictive performances of the three bleeding scores in stratifying the risk of 30-day major bleeding postpercutaneous coronary intervention in patients with dual-antiplatelet therapy. METHODS: In this post hoc subanalysis of the GLOBAL LEADERS trial, the primary safety objective (bleeding according to the Bleeding Academic Research Consortium [BARC] criteria [type 3 or 5]) was assessed at 30 days according to the three scores in the overall population, and in patients with acute (ACS) and chronic coronary syndrome (CCS). RESULTS: In a total of 15,968 patients, we calculated all three scores in 14,709 (92.1%). Irrespective of clinical presentation, the PRECISE-DAPT (c-statistics: 0.648, 0.653, and 0.641, respectively), CRUSADE (c-statistics: 0.641, 0.639, and 0.644, respectively), and ACUITY (c-statistics: 0.633, 0.638, and 0.623, respectively) scores were no significant between-score differences in discriminatory performance for BARC 3 or 5 bleeding up to 30 days, and similarly the PRECISE-DAPT score had a comparable discriminative capacity according to the integrated discrimination improvement when compared with the other scores. In ACS, the CRUSADE score had a poor calibration ability (Hosmer-Lemeshow goodness-of-fit [GOF] chi-square = 15.561, p = 0.049), whereas in CCS, the PRECISE-DAPT score had poor calibration (GOF chi-square = 15.758, p = 0.046). CONCLUSION: The PRECISE-DAPT score might be clinically useful in the overall population and ACS patients for the prediction of short-term major bleeding considering its discriminative and calibration abilities. Georg Thieme Verlag KG Stuttgart · New York.
RCT Entities:
BACKGROUND: The utility of the PRECISE-DAPT score in predicting short-term major bleeding, either alone, or in comparison with the CRUSADE and ACUITY scores, has not been investigated. This analysis compared the predictive performances of the three bleeding scores in stratifying the risk of 30-day major bleeding postpercutaneous coronary intervention in patients with dual-antiplatelet therapy. METHODS: In this post hoc subanalysis of the GLOBAL LEADERS trial, the primary safety objective (bleeding according to the Bleeding Academic Research Consortium [BARC] criteria [type 3 or 5]) was assessed at 30 days according to the three scores in the overall population, and in patients with acute (ACS) and chronic coronary syndrome (CCS). RESULTS: In a total of 15,968 patients, we calculated all three scores in 14,709 (92.1%). Irrespective of clinical presentation, the PRECISE-DAPT (c-statistics: 0.648, 0.653, and 0.641, respectively), CRUSADE (c-statistics: 0.641, 0.639, and 0.644, respectively), and ACUITY (c-statistics: 0.633, 0.638, and 0.623, respectively) scores were no significant between-score differences in discriminatory performance for BARC 3 or 5 bleeding up to 30 days, and similarly the PRECISE-DAPT score had a comparable discriminative capacity according to the integrated discrimination improvement when compared with the other scores. In ACS, the CRUSADE score had a poor calibration ability (Hosmer-Lemeshow goodness-of-fit [GOF] chi-square = 15.561, p = 0.049), whereas in CCS, the PRECISE-DAPT score had poor calibration (GOF chi-square = 15.758, p = 0.046). CONCLUSION: The PRECISE-DAPT score might be clinically useful in the overall population and ACSpatients for the prediction of short-term major bleeding considering its discriminative and calibration abilities. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Masafumi Ono; Yoshinobu Onuma; Hideyuki Kawashima; Hironori Hara; Chao Gao; Rutao Wang; Neil O'Leary; Edouard Benit; Luc Janssens; Maurizio Ferrario; Aleksander Żurakowski; Marcello Dominici; Kurt Huber; Paweł Buszman; Scot Garg; Joanna J Wykrzykowska; Jan J Piek; Peter Jüni; Christian Hamm; Stephan Windecker; Pascal Vranckx; Efthymios N Deliargyris; Deepak L Bhatt; Robert F Storey; Marco Valgimigli; Patrick W Serruys Journal: Catheter Cardiovasc Interv Date: 2022-05-02 Impact factor: 2.585