External validity of the PRECISE-DAPT score in patients undergoing PCI: a systematic review and meta-analysis.
Eur Heart J Cardiovasc Pharmacother
; 9(8): 709-721, 2023 Dec 14.
Article
en En
| MEDLINE
| ID: mdl-37634083
ABSTRACT
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 ANDRESULTS:
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.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Inhibidores de Agregación Plaquetaria
/
Intervención Coronaria Percutánea
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Idioma:
En
Revista:
Eur Heart J Cardiovasc Pharmacother
Año:
2023
Tipo del documento:
Article