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Predictive Value of PRECISE_DAPT Scoring on Bleeding Risk in Patients with Acute Coronary Syndrome and Diabetes Mel-litus Treated with Dual Antiplatelet Therapy
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- Author:
- No author available
- Journal Title:
- Prevention and Treatment of Cardio-Cerebral-Vascular Disease
- Issue:
- 4
- DOI:
- 10.3969/j.issn.1009_816x.2019.04.005
- Key Word:
- PRECISE_DAPT评分;急性冠状动脉综合征;糖尿病;双联抗血小板治疗;经皮冠状动脉介入治疗;出血风险预测
Abstract： 目的 探讨PRECISE_DAPT评分对接受经皮冠状动脉介入手术(PCI)的急性冠状动脉综合征(ACS)合并糖尿病(DM)患者双联抗血小板(DAPT)治疗后出血风险的预测价值.方法 选择ACS合并DM患者200例,PCI术后接受DAPT治疗,随访时间为1年,记录出血事件发生情况,根据是否发生出血事件分为出血组和未出血组,评价PRE-CISE_DAPT评分对出血事件的预测价值.结果 (1)随访期间共有66例(33.00％)发生出血事件,最常见为消化道出血,出血组平均年龄、年龄>65岁比例和治疗前PRECISE_DAPT评分高于未出血组(P<0.05);(2)PRECISE_DAPT评分与出血事情呈正相关(r=0.63,P<0.01),出血发生率随着PRECISE_DAPT评分分级增加而升高,其中≥25分组出血发生危险是≤10分组的5.76倍(P<0.05);(3)PRECISE_DAPT评分对于出血风险预测的最佳截断点为16.84,其曲线下面积(AUC)为0.71(Z=5.60,P<0.05,95％CI=0.53～0.85),此时的诊断敏感度为82.27％,特异度为64.09％,阳性预测值为86.27％,阴性预测值为55.73％,准确率为73.37％.结论 ACS合并DM患者接受PCI术后出血患者的PRECISE_DAPT评分明显升高,该评分对于出血事件有一定的预测价值.
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