Derivation and Validation of the PRECISE-HBR Score to Predict Bleeding After Percutaneous Coronary Intervention
Authors' conclusion
The PRECISE-HBR score is a contemporary, simple 7-item risk score to predict bleeding after percutaneous coronary intervention, offering a moderate improvement in discrimination over multiple existing scores.
Study context
- Population
- Patients undergoing PCI (4 real-world registries and the XIENCE V USA trial; external: MASTER DAPT and STOPDAPT-2)derivation cohort
- Participants
- 29,188 patients
- Comparison
- PRECISE-HBR vs PRECISE-DAPT and other risk scores
- Outcome
- BARC 3 or 5 bleeding
- Follow-up
- 1 year
Methodological detailsinternal (apparent and cross-) validation, external validation in 2 trial cohorts, Fine-Gray model
- Internal (apparent and cross-) validation
- External validation in 2 trial cohorts
- Fine-Gray model
Performance
As reported in the abstract
Discrimination (AUC) for 1-year BARC 3 or 5 bleeding
PRECISE-HBR
- AUC, apparent validation
- 0.73 (95% CI, 0.71-0.74)
- AUC, cross-validation
- 0.72 (95% CI, 0.70-0.73)
- AUC, MASTER DAPT
- 0.74 (95% CI, 0.68-0.80)
- AUC, STOPDAPT-2
- 0.73 (95% CI, 0.66-0.79)
PRECISE-HBR
AUC, apparent validation0.73 (95% CI, 0.71-0.74)
AUC, cross-validation0.72 (95% CI, 0.70-0.73)
AUC, MASTER DAPT0.74 (95% CI, 0.68-0.80)
AUC, STOPDAPT-20.73 (95% CI, 0.66-0.79)
- Cross-validation
- ΔAUC 0.01; P = 0.02
- MASTER DAPT
- ΔAUC 0.05; P = 0.004
- STOPDAPT-2
- ΔAUC 0.02; P = 0.20
Further findings
High bleeding risk by 23-point cutoff (derivation cohort) · 1 year
- Cutoff of 23 points identified patients with 1-year Bleeding Academic Research Consortium (BARC) 3 or 5 bleeding risk ≥4%
- 11 414 (39.1%)
Alternative score (acute MI on admission instead of white blood cell count)
- Similar predictive ability
Original publication
Derivation and Validation of the PRECISE-HBR Score to Predict Bleeding After Percutaneous Coronary Intervention. Circulation. Published 27 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it