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Clinical Evidence and Methodology

EVIDENCE SYNTHESIS

Clinical Reference Hub

Curated insights • How it Works • Practical Pearls • Evidence Base

CLINICAL INSIGHT

When to Use

When to Use

  • Decision-making for the duration of Dual Antiplatelet Therapy (DAPT) after coronary stenting.
  • Identifying patients who may benefit from extending DAPT beyond 12 months vs. those at high bleeding risk.
  • Evaluation at the 12-month mark post-PCI.
CLINICAL INSIGHT

How it Works

Scoring Variables

Age ≥ 75 ( −2 ), 65-74 ( −1 ), <65 ( 0 )
Cigarette Smoking
Diabetes Mellitus
MI at Presentation
Prior MI or PCI
Stent Diameter < 3mm
Paclitaxel-eluting Stent
Congestive Heart Failure / LVEF < 30%
Vein Graft Stent

Interpretation

Score < 2
Score ≥ 2
CLINICAL INSIGHT

Practical Pearls

Ischemia vs. Bleeding

The DAPT score is a "trade-off" tool. A high score suggests that the risk of stent thrombosis or recurrent MI is high enough to justify the increased bleeding risk of prolonged dual antiplatelet therapy.

CLINICAL INSIGHT

Next Steps

Complementary Calculators

CLINICAL INSIGHT

Evidence Base

Derivation Study

Development and Validation of a Prediction Rule to Guide the Duration of Dual Antiplatelet Therapy.

Yeh RW, et al.JAMA.2016

DAPT Score

DAPT Score: Estimates the risk-benefit ratio of continuing dual antiplatelet therapy beyond 12 months after PCI.
EVIDENCE SYNTHESIS

Clinical Reference Hub

Curated insights • How it Works • Practical Pearls • Evidence Base

CLINICAL INSIGHT

When to Use

When to Use

  • Decision-making for the duration of Dual Antiplatelet Therapy (DAPT) after coronary stenting.
  • Identifying patients who may benefit from extending DAPT beyond 12 months vs. those at high bleeding risk.
  • Evaluation at the 12-month mark post-PCI.
CLINICAL INSIGHT

How it Works

Scoring Variables

Age ≥ 75 ( −2 ), 65-74 ( −1 ), <65 ( 0 )
Cigarette Smoking
Diabetes Mellitus
MI at Presentation
Prior MI or PCI
Stent Diameter < 3mm
Paclitaxel-eluting Stent
Congestive Heart Failure / LVEF < 30%
Vein Graft Stent

Interpretation

Score < 2
Score ≥ 2
CLINICAL INSIGHT

Practical Pearls

Ischemia vs. Bleeding

The DAPT score is a "trade-off" tool. A high score suggests that the risk of stent thrombosis or recurrent MI is high enough to justify the increased bleeding risk of prolonged dual antiplatelet therapy.

CLINICAL INSIGHT

Next Steps

Complementary Calculators

CLINICAL INSIGHT

Evidence Base

Derivation Study

Development and Validation of a Prediction Rule to Guide the Duration of Dual Antiplatelet Therapy.

Yeh RW, et al.JAMA.2016