Association between PRECISE-DAPT score and clinical outcomes: a subgroup analysis of the DAPT-TR registry
Makaleler > Tam Makale · 2026
Yazarlar: Berat Uğuz, Ahmet Öz, Ömer Kertmen, İlyas Çetin, Lütfü Bekar, Ferit Büyük, Serkan Asil, Mehmet Cansel, Hakan Taşolar, Mehdi ZOGHİ
Cardiovascular Journal of Africa, Uluslararası, Wos, 2026, cilt 37, ss 198-202
Özet
OBJECTIVE: This study aimed to evaluate whether a PRECISE-DAPT score ≥ 25 identifies a high-risk phenotype associated with adverse ischemic and bleeding outcomes, hospitalisation, and mortality among patients treated with fixed-dose acetylsalicylic acid and clopidogrel. METHODS: We conducted a prespecified subgroup analysis of the DAPT-TR registry, a prospective, multicentre observational cohort including 1,500 patients who were initiated on fixed-dose combination dual antiplatelet therapy (aspirin 75 mg/day plus clopidogrel 75 mg/day) for the treatment of acute and stable coronary artery disease. Patients were stratified according to PRECISE-DAPT score categories (≥ 25 vs < 25). Six-month clinical outcomes, including all-cause and cardiovascular hospitalisation, myocardial infarction, stent thrombosis, BARC type 1 bleeding, all-cause mortality, cardiovascular mortality, and stroke, were compared between groups. Multivariable logistic regression analysis was performed to evaluate independent associations between PRECISE-DAPT score categories and clinical outcomes. RESULTS: Of 1,500 patients, 344 (22.9%) had a PRECISE-DAPT score ≥ 25. Compared with patients with a PRECISE-DAPT score < 25, those with a PRECISE-DAPT score ≥ 25 were older (mean age 71.9 vs. 60.8 years; p < 0.001), more frequently female, and had significantly more comorbidities and reduced LVEF. At 6 months, patients with a PRECISE-DAPT score ≥ 25 experienced higher rates of all-cause hospitalisation (19.5% vs. 10.9%; p < 0.001), cardiovascular hospitalisation (11.6% vs. 6.7%; p = 0.003), stent thrombosis (2.6% vs. 1.0%; p = 0.029), and BARC type 1 bleeding (7.5% vs. 2.2%; p < 0.001). All-cause mortality (1.7% vs. 0.2%; p = 0.003) and cardiovascular mortality (1.2% vs. 0.1%; p = 0.011) were also significantly higher. After adjustment, a PRECISE-DAPT score ≥ 25 remained independently associated with mortality (OR: 3.8; 95% CI: 1.2-12.1) and hospitalisation (OR: 2.1; 95% CI: 1.5-3.1). CONCLUSION: A PRECISE-DAPT score ≥ 25 delineates a clinically vulnerable subgroup with elevated ischemic, haemorrhagic, and mortality risks, even under uniform fixed-dose DAPT. These findings suggest that the PRECISE-DAPT score may serve as a multidimensional prognostic tool beyond bleeding risk stratification.