Applicability of the PRECISE-DAPT score in elderly patients with myocardial infarction  

作　　者：Albert Ariza-Sole Francesc Formiga Manuel Martinez-Selles Maria T Vidan Jaime Aboal 

机构地区：[1]department of Cardiology,Hospital Universitari de Bellvitge,L'Hospitalet de Llobregat,Barcelona [2]Geriatrics Medicine Unit,Internal Medicine Department.Hospital Universitari de Bellvitge,L'Hospitalet de Llobregat,Barcelona [3]Department of Cardiology,Hospital General Universitario Gregorio Maranon,Madrid [4]Geriatrics Medicine Department,Hospital General Universitario Gregorio Marahon,Madrid [5]Department of Cardiology,Hospital Universitari Josep Trueta,Girona

出　　处：《Journal of Geriatric Cardiology》2018年第12期713-717,共5页老年心脏病学杂志（英文版）

摘　　要：Background Elderly patients with acute coronary syndromes(ACS)are at higher risk both for ischemic and bleeding complications.Current guidelines recommend the PRECISE-DAPT score for bleeding risk stratification in this setting,but no study assessed its applicability in elderly patients.This study aimed to assess the performance of the PRECISE-DAPT score in a series of non-selected elderly patients with ACS from routine clinical practice.Methods The IFFANIAM registry included prospectively patients aged>75 years with ST segment elevation myocardial infarction(STEMI).Main outcome measured was the incidence of relevant bleeding after discharge(bleeding leading to hospital readmission,need for transfusion,intervention,stop of antithrombotic drugs or death).Bleeding risk was classified:(A)according to PRECISE-DAPT values above or not the recommended cut-off point(>25);and(B)according to the quartiles of PRECISE-DAPT values observed in the IFFANIAM series(QI:<30;Q2:30-35;Q3:36-44;Q4:>45).Results A total of 208 patients were included.Mean age was 81.9±4.5 years.Most patients(92.6%)had a PRECISE-DAPT value>25.A total of 25 patients(12.0%)had bleeding events and 49 patients(23.6%)died.No significant differences regarding the incidence of bleeding were observed according to the recommended cutt of point>25.However,a progressive increase in the incidence of bleeding was observed across PRECISE-DAPT quartiles observed in this series(P=0.038).Conclusions The vast majority of elderly patients have PRECISE-DAPT values above the recommended cut-off point for bleeding risk.Using different cut-off points could be a more rational approach for predicting bleeding risk in these complex patients.

关 键 词：Acute CORONARY SYNDROMES BLEEDING Prognosis The elderly 

分 类 号：R[医药卫生]