The Cardiovascular
ToolsCalculators

PRECISE-DAPT Score

Estimates out-of-hospital bleeding risk to guide dual antiplatelet therapy duration after coronary stenting.

PRECISE-DAPT Score
Age
years
Creatinine clearance
mL/min
Haemoglobin
White blood cell count
x10^9/L
Previous spontaneous bleeding
Complete the fields above to see the result.

When to use

  • Weighing the duration of dual antiplatelet therapy after coronary stent implantation.

Formula

Nomogram-based score (0-100) from age, creatinine clearance, haemoglobin, white blood cell count, and previous spontaneous bleeding (fixed 26 points if present); age contributes 0-19 points (>=50 to >=90y), creatinine clearance 0-25 points (100 to 0 mL/min), haemoglobin 0-15 points (12 to <=10 g/dL), and white blood cell count 0-15 points (5 to >=20x10^9/L), each linearly interpolated between the published nomogram anchor points. Score >=25 defines high bleeding risk.

Pearls and pitfalls

  • Derived from a pooled analysis of eight DAPT-duration randomised trials and externally validated in the PLATO trial and BernPCI registry.
  • A score >=25 identifies patients in whom shortening DAPT to 3-6 months avoided excess bleeding without loss of ischaemic benefit.

References

  1. Costa F, van Klaveren D, James S, et al. Lancet. 2017;389(10073):1025-1034.