Value of DAPT score to predict adverse outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: A post-hoc analysis from the AFCAS registry

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.