Coronary disease & ACSCohort study
Bleeding risk prediction after acute myocardial infarction-integrating cancer data: the updated PRECISE-DAPT cancer score
- Retrospective cohort study
- nationally linked registry cohort
Authors' conclusion
Adding cancer to the PRECISE-DAPT score identifies the majority of patients with cancer as HBR and can improve its discrimination ability without undermining its performance in patients without cancer.
Study context
- Population
- STEMI patients, UK MINAP and HES registries, 2005–20194,569 with cancer
- Participants
- 216,709 patients
- Exposure
- Modified PRECISE-DAPT score vs original PRECISE-DAPT score
- Outcome
- Major bleeding
- Follow-up
- 1 year
Main finding
As reported in the abstract
Original score
.60
C-statistic
Modified score
.64
C-statistic · C-statistic in patients without cancer .63
Modified score vs Original scoreHazard ratio (95% CI)
Major bleeding
1.03(1.03–1.04)
patients without cancer
1.03(1.03–1.04)
- Net reclassification index
- .07
Observational data: associations, not effects.
Further findings
Risk classification of cancer patients
HBR
Low or very low bleeding risk Modified score 0 · Original score 21.6%
Moderate bleeding risk Modified score 6.0%
Bleeding rates by modified score risk category
- High bleeding risk
- 6.3%
- Moderate bleeding risk
- 3.8%
- Low bleeding risk
- 2.9%
- Very low bleeding risk
- 2.2%
Original publication
Bleeding risk prediction after acute myocardial infarction-integrating cancer data: the updated PRECISE-DAPT cancer score. Eur Heart J. Published 17 July 2024. doi:10.1093/eurheartj/ehae463
Summarised from the published abstract; every number is checked against it