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Title: Associations between DAPT score and long-term mortality post PCI.
Author: Tan, M.
Dinh, D.
Gayed, D.
Liang, D.
Brennan, A.
Duffy, S.
Clark, D.
Ajani, A.
Oqueli, Ernesto
Roberts, L.
Reid, C.
Freeman, M.
Chandrasekhar, J.
Issue Date: 2021
Conference Name: 69th CSANZ Annual Scientific Meeting 43rd Annual Scientific Meeting of the International Society for Heart Research ANZET 21
Conference Date: August 4-7
Conference Place: Online
Abstract: Introduction: The dual antiplatelet (DAPT) score was developed to identify patients more likely to derive benefit (score ≥2) or harm (score <2) from DAPT beyond 1-year post PCI. We sought to examine long-term mortality after PCI by the DAPT score in patients treated with DAPT per local guidelines. Methods: We examined data from the MIG PCI database from 2005 to 2018 in whom the DAPT score could be derived and grouped them as score ≥2 or <2. Long-term mortality was assessed from National Death Index linkage. The primary endpoint was long-term mortality examined using survival analysis. Secondary endpoints included 30-day ischaemic outcomes and in-hospital major bleeding. Results: Out of 27,740 patients in the study, 9,401 (33.9%) had DAPT score ≥2. They were younger and included more females and higher prevalence of renal impairment. DAPT score ≥2 patients had higher in-hospital major bleeding, 30-day mortality, MI and target vessel revascularisation. DAPT score ≥2 patients had lower long-term survival to 12 years (p<0.001 for all). Conclusion: A third of all-comer PCI patients had DAPT score ≥2 with greater short-term risk of ischaemic and bleeding outcomes, as well as long-term mortality. Theoretically, those with DAPT score ≥2 would benefit from longer duration of DAPT as ischaemic risk outweighs bleeding risk. However, given our finding of increased short-term bleeding risk and long-term mortality, dynamic bleeding risk assessment should be undertaken to guide pharmacotherapy strategies.
Internal ID Number: 01756
Type: Conference
Appears in Collections:Research Output

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