Exam

DAPT Score

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DAPT Score, Dual-Antiplatelet Therapy Decision Rule

  • Indications
  1. Decision Rule to individualize duration of Dual Antiplatelet Therapy (DAPT) after MI or PCI
  • Criteria
  1. Age (Select one of the following)
    1. Score -2: Age 75 years or older
    2. Score -1: Age 65 to 75 years old
    3. Score 0: Age <65 years old
  2. Add 1 point for each of the following criteria
    1. Current Tobacco smoker
    2. Diabetes Mellitus
    3. Myocardial Infarction at presentation
    4. Prior Myocardial Infarction or PCI (Percutaneous Coronary Intervention)
    5. Stent diameter <3 mm
    6. Paclitaxel-eluting stent
  3. Add 2 points for each of the following criteria
    1. Congestive Heart Failure or LV ejection fraction <30%
    2. Saphenous vein graft PCI
  • Interpretation
  1. Score 2 or greater
    1. Prolonged use of dual antiplatelet drugs is supported (DAPT benefits outweight risks)
  2. Score <2
    1. Shorter duration of dual antiplatelet drugs is preferred (DAPT risks outweigh benefits)
  • Resources
  1. ACC: Using the DAPT Score to Predict Stent Thrombosis vs. Bleeding
    1. https://www.acc.org/latest-in-cardiology/features/dual-antiplatelet-therapy-dapt-focused-update-hub/resources/using-the-dapt-score-to-predict-stent-thrombosis-vs-bleeding
  • References
  1. Levine (2016) J Am Coll Cardiol +PMID:27036918 [PubMed]
  2. Yeh (2016) JAMA 315(16):1735-9 [PubMed]