Author + information
- Tabassome Simona,b,
- Etienne Puymirata,b,
- Francois Schielea,b,
- Pierre Costea,b,
- Denis Angoulvanta,b,
- Khalife Khalifea,b,
- Guillaume Caylaa,b,
- Pascal Motreffa,b,
- Ferrieres Jeana,b and
- Nicolas Danchina,b
Background: In the DAPT trial, the DAPT score allowed to determine which patients benefited most from prolonged dual antiplatelet therapy. The value of this score in real-life populations, has not yet been studied.
Methods: We used the FAST-MI 2005, a nationwide survey of AMI patients hospitalised in 223 institutions, to determine the 5-year survival, MACE-free survival (death, MI or stroke), and severe bleeding complications according to a modified DAPT score (stent diameter replaced by multivessel PCI). From the 3,670 patients included, 1,244 who had a PCI were alive with no intercurrent events, on dual antiplatelet therapy at 1 year, and had information on prolonged clopidogrel use available.
Results: Mean age of the whole population was 63 ± 13 yrs. Patients with DAPT score ≥2 were younger than patients with a lower score (59 ± 11 v 77 ± 6 years). DAPT was prolonged beyond 1 year in 675 patients (54%), in a similar proportion in both DAPT score groups. Patients on prolonged clopidogrel treatment had a similar age (63 ± 12 years) and a lower GRACE score (136 ± 30 vs 140 ± 31) compared with those without prolonged DAPT. They had higher survival and MACE-free survival, irrespective of the DAPT score category. Bleeding events did not differ within each DAPT score group. (Table)
Conclusions: In a real-world population of post-AMI patients having undergone PCI at the acute stage, the DAPT score did not adequately discriminate between those with or without benefit of prolonged dual antiplatelet therapy beyond 1 year.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Angiography, Intra-Vascular Imaging, Revascularization and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1166-317
- 2017 American College of Cardiology Foundation