Evaluation of the DAPT Score in Patients Who Undergo Percutaneous Coronary Intervention in England and Wales

Abstract

This study aims to evaluate the temporal changes in DAPT score and determine whether there is an association between DAPT score and mortality. We analyzed all patients who underwent PCI in England and Wales 2007–2014. Statistical analyses were performed evaluating the DAPT score according to ≥2 and <2 cutoffs. Trends in DAPT score and logistic regressions were used to determine the association between DAPT score and 30 day, 1 year and 3 year mortality. A total of 243,440 patients were included in the analysis and the proportion of patients with DAPT score ≥ 2 was 35.6% (n = 86,550). The trend in DAPT score ≥ 2 showed an overall decline over time from 38.5% in 2007 to 34.5% in 2014. In more recent years, patients were older and a greater proportion were diabetic and had myocardial infarction on presentation and there was a significant decline in patients receiving paclitaxel stent (23.7% in 2007 to 0.2% in 2014). Patients with DAPT score ≥ 2 were more likely to be male, have previous CABG and have glycoprotein IIB/IIIa inhibitors. At 3 year follow up there was a significant difference in death compared DAPT ≥ 2 vs <2 (5.2% vs 5.5%, p < 0.001). DAPT score ≥ 2 was associated with reduced mortality at 1 year (OR 0.87 95%CI 0.82–0.92, p < 0.001) and 3 years (OR 0.82 95%CI 0.79–0.86, p < 0.001) after adjustments. These findings suggest that the DAPT score classifies 1 in 3 patients as having scores ≥2 and these patients have reduced odds of long-term mortality.