Abstract

Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI.

Methods and results: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events. At 12-month follow-up, patients with a DAPT score ≥ 1 had a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.004, p = 0.006, and p = 0.013, respectively), but a similar bleeding rate (p = 0.66), versus those with a DAPT score < 1. In a subgroup of patients at high risk of stroke who received triple therapy for 1 month only, DAPT score ≥ 1 was associated with a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.002, p = 0.015, and p = 0.039, respectively), but a similar bleeding rate (p = 0.81).

Conclusions: In AF patients undergoing PCI, a DAPT score ≥ 1 was associated with a higher incidence of thrombotic events, and a similar incidence of bleeding events, compared with a DAPT score < 1. These results were consistent in patients at high risk of stroke who received triple therapy for 1 month.