DAPT score
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sadaf Sharfaei M.D.[2]
Synonyms and keywords: Dual Antiplatelet Therapy score; DAPT (Dual Antiplatelet Therapy) score; DAPT score calculator; Dual Antiplatelet Therapy score calculator; DAPT (Dual Antiplatelet Therapy) score calculator
Overview
The DAPT score is a clinical prediction score assessing ischemic and bleeding risks at 12 to 30 months following percutaneous coronary intervention (PCI) to inform the duration of dual antiplatelet therapy (DAPT). The score was derived from the DAPT study (ClinicalTrials.gov: NCT00977938) and initially validated in the PROTECT trial (ClinicalTrials.gov: NCT00476957).
DAPT Score
The DAPT score is a simplified clinical prediction score designed to assess the benefit-risk tradeoff between ischemia reduction (myocardial infarction or stent thrombosis) and bleeding increase (moderate or severe hemorrhage) associated with continued thienopyridine plus aspirin versus aspirin alone beyond one year after PCI based on 11,648 patients enrolled in the DAPT study (derivation cohort) and 8,136 patients enrolled in the PROTECT trial (validation cohort).[1]
DAPT Score Calculator
Shown below is the calculator for the DAPT score (check all the boxes that apply):
Interpretation
- Score ≥2 (high score): benefit-risk favoring prolonged DAPT over aspirin alone
- Greater ischemic reduction (2.7% for prolonged DAPT vs 5.7% for aspirin alone; difference, −3.0% [95% CI, −4.1% to −2.0%]; NNT=34)
- Smaller bleeding increase (1.8% for prolonged DAPT vs 1.4% for aspirin alone; difference, 0.4% [95% CI, −0.3% to 1.0%])
- Score <2 (low score): benefit-risk favoring aspirin alone over prolonged DAPT
- Smaller ischemic reduction (1.7% for prolonged DAPT vs 2.3% for aspirin alone; difference, −0.7% [95% CI, −1.4% to 0.1%])
- Greater bleeding increase (3.0% for prolonged DAPT vs 1.4% for aspirin alone; difference, 1.5% [95% CI, 0.8% to 2.3%]; NNH=64)
See also
References
- ↑ Yeh, Robert W.; Secemsky, Eric A.; Kereiakes, Dean J.; Normand, Sharon-Lise T.; Gershlick, Anthony H.; Cohen, David J.; Spertus, John A.; Steg, Philippe Gabriel; Cutlip, Donald E.; Rinaldi, Michael J.; Camenzind, Edoardo; Wijns, William; Apruzzese, Patricia K.; Song, Yang; Massaro, Joseph M.; Mauri, Laura (2016). "Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention". JAMA. 315 (16): 1735. doi:10.1001/jama.2016.3775. ISSN 0098-7484.