Comparative external validation of the PRECISE-DAPT and PARIS risk scores in 4424 acute coronary syndrome patients treated with prasugrel or ticagrelor

Bianco, Matteo; D'ascenzo, Fabrizio; Raposeiras Roubin, Sergio; Kinnaird, Tim; Peyracchia, Mattia; Ariza-Solé, Albert; Cerrato, Enrico; Manzano-Fernández, Sergio; Gravinese, Carol; Templin, Christian; Destefanis, Paola; Velicki, Lazar; Luciano, Alessia; Xanthopoulou, Ioanna; Rinaldi, Mauro; Rognoni, Andrea; Varbella, Ferdinando; Boccuzzi, Giacomo; Omedè, Pierluigi; Montabone, Andrea; Bernardi, Alessandro; Taha, Salma; Rossini, Roberta; Durante, Alessandro; Gili, Sebastiano; Magnani, Giulia; Autelli, Michele; Grosso, Alberto; Blanco, Pedro Flores; Giustetto, Carla; Garay, Alberto; Quadri, Giorgio; Queija, Berenice Caneiro; Srdanovic, Ilija; Paz, Rafael Cobas; Fernández, María Cespón; Pousa, Isabel Muñoz; Gallo, Diego; Morbiducci, Umberto; Dominguez-Rodriguez, Alberto; Lopez-Cuenca, Ángel; Cequier, Angel; Alexopoulos, Dimitrios; Iñiguez-Romo, Andres; Pozzi, Roberto; Assi, Emad Abu; Valgimigli, Marco.

doi:10.1016/j.ijcard.2019.11.132

Background: The PRECISE-DAPT and PARIS risk scores (RSs) were recently developed to help clinicians at individualizing the optimal dual antiplatelet therapy duration (DAPT) after percutaneous coronary intervention (PCI). Nevertheless, external validation of these RSs it has not yet been performed in ACS (acute coronary syndrome) patients treated with prasugrel or ticagrelor in a real- world scenario. Methods: 4424 ACS patients who underwent PCI and survived to hospital discharge, from January 2012 to December 2016 at 12 European centers, were included. PRECISE-DAPT and PARIS bleeding RS, as well as PARIS ischemic RS, were computed, and their performance at predicting major bleeding (MB; BARC type 3 or 5) and ischemic events (MI and stent thrombosis) during follow up was compared. Results: After a median follow-up of 14 (interquartile range 12–20.9) months, 83 (1.88%) patients developed MB and 133 (3.0%) suffered an ischemic episode. PRECISE-DAPT performed better than PARIS bleeding RS (c-statistic = 0.653 vs. 0.593; p =.01 for comparison) in predicting MB. The RSs performance for MB prediction remained consistent in STEMI patients (c-statistic = 0.632 vs 0.575) or in those treated with prasugrel (c-statistic = 0.623 vs 0.586). PARIS ischemic RS exhibited superior discrimination in predicting ischemic complications compared to PRECISE-DAPT (c-statistic = 0.604 vs 0.568 p =.05 for comparison). Conclusion: Our data provide support to the use of PRECISE-DAPT in MB risk stratification for patients receiving DAPT in form of aspirin and prasugrel or ticagrelor whereas the PARIS ischemic RS has potential to complement the risk prediction with respect to ischemic events.

Comparative external validation of the PRECISE-DAPT and PARIS risk scores in 4424 acute coronary syndrome patients treated with prasugrel or ticagrelor / Bianco, Matteo; D'ascenzo, Fabrizio; Raposeiras Roubin, Sergio; Kinnaird, Tim; Peyracchia, Mattia; Ariza-Solé, Albert; Cerrato, Enrico; Manzano-Fernández, Sergio; Gravinese, Carol; Templin, Christian; Destefanis, Paola; Velicki, Lazar; Luciano, Alessia; Xanthopoulou, Ioanna; Rinaldi, Mauro; Rognoni, Andrea; Varbella, Ferdinando; Boccuzzi, Giacomo; Omedè, Pierluigi; Montabone, Andrea; Bernardi, Alessandro; Taha, Salma; Rossini, Roberta; Durante, Alessandro; Gili, Sebastiano; Magnani, Giulia; Autelli, Michele; Grosso, Alberto; Blanco, Pedro Flores; Giustetto, Carla; Garay, Alberto; Quadri, Giorgio; Queija, Berenice Caneiro; Srdanovic, Ilija; Paz, Rafael Cobas; Fernández, María Cespón; Pousa, Isabel Muñoz; Gallo, Diego; Morbiducci, Umberto; Dominguez-Rodriguez, Alberto; Lopez-Cuenca, Ángel; Cequier, Angel; Alexopoulos, Dimitrios; Iñiguez-Romo, Andres; Pozzi, Roberto; Assi, Emad Abu; Valgimigli, Marco.. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - ELETTRONICO. - 301:(2020), pp. 200-206. [10.1016/j.ijcard.2019.11.132]

Titolo:	Comparative external validation of the PRECISE-DAPT and PARIS risk scores in 4424 acute coronary syndrome patients treated with prasugrel or ticagrelor
Autori:	Bianco, Matteo D'ASCENZO, FABRIZIO Raposeiras Roubin, Sergio Kinnaird, Tim Peyracchia, Mattia Ariza-Solé, Albert Cerrato, Enrico Manzano-Fernández, Sergio Gravinese, Carol Templin, Christian Destefanis, Paola Velicki, Lazar Luciano, Alessia Xanthopoulou, Ioanna RINALDI, MAURO Rognoni, Andrea Varbella, Ferdinando Boccuzzi, Giacomo Omedè, Pierluigi Montabone, Andrea Bernardi, Alessandro Taha, Salma Rossini, Roberta Durante, Alessandro Gili, Sebastiano Magnani, Giulia Autelli, Michele Grosso, Alberto Blanco, Pedro Flores Giustetto, Carla Garay, Alberto Quadri, Giorgio Queija, Berenice Caneiro Srdanovic, Ilija Paz, Rafael Cobas Fernández, María Cespón Pousa, Isabel Muñoz GALLO, DIEGO MORBIDUCCI, UMBERTO Dominguez-Rodriguez, Alberto Lopez-Cuenca, Ángel Cequier, Angel Alexopoulos, Dimitrios Iñiguez-Romo, Andres Pozzi, Roberto Assi, Emad Abu Valgimigli, Marco. mostra contributor esterni nascondi contributor esterni
Data di pubblicazione:	2020
Rivista:	INTERNATIONAL JOURNAL OF CARDIOLOGY
Digital Object Identifier (DOI):	http://dx.doi.org/10.1016/j.ijcard.2019.11.132
Appare nelle tipologie:	1.1 Articolo in rivista

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