Development of a risk score for predicting the benefit versus harm of extending dual antiplatelet therapy beyond 6 months following percutaneous coronary intervention for stable coronary artery disease

Guy Witberg, Ygal Plakht, Tamir Bental, Becca S Feldman, Maya Leventer-Roberts, Amos Levi, Hagit Gabay, Ran Balicer, Yariv Gerber and Ran Kornowski

PLOS ONE, 2019, vol. 14, issue 2, 1-16

Abstract: Background: Decisions on dual antiplatelet therapy (DAPT) duration should balance the opposing risks of ischaemia and bleeding. Our aim was to develop a risk score to identify stable coronary artery disease (SCAD) patients undergoing PCI who would benefit or suffer from extending DAPT beyond 6 months. Methods: Retrospective analysis of a cohort of patients who completed 6 months of DAPT following PCI. Predictors of ischaemic and bleeding events for the 6–12 month period post-PCI were identified and a risk score was developed to estimate the likelihood of benefiting from extending DAPT beyond 6 months. Incidence of mortality, ischaemic and bleeding events for patients treated with DAPT for 6 vs. 6–12 months, was compared, stratified by strata of the risk score. Results: The study included 2,699 patients. Over 6 months’ follow up, there were 78 (2.9%) ischaemic and 43 (1.6%) bleeding events. Four variables (heart failure, left ventricular ejection fraction ≤30%, left main or three vessel CAD, status post (s/p) PCI and s/p stroke) predicted ischemic events, two variables (age>75, haemoglobin

Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0209661

DOI: 10.1371/journal.pone.0209661

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