이달의 kcj Hot Article / 2026년 3월
Validation of the Asian-Dual Antiplatelet Therapy Score |
| 저자 |
Young-Hae Go, MD,1
Jeehoon Kang, MD,2,3
Junpil Yun, MD,2
Jin-Eun Song, MD,2
Doyeon Hwang, MD,2
Jung-Kyu Han, MD,2
Han-mo Yang, MD,2
Kyung Woo Park, MD,1,2
Hyun-Jae Kang, MD,1,2
Bon-Kwon Koo, MD,1,2
and Hyo-Soo Kim, MD1,2 |
| 소속 |
1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
2Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
3Division of Cardiology, Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea. |
Background and ObjectivesAn individualized approach is recommended for prescribing dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). Asian-DAPT (ADAPT) scores were developed to assess both ischemic and bleeding risks in Asian populations. This study aimed to validate the ADAPT scores for predicting ischemic and bleeding events in patients receiving DAPT. MethodsPatients from the Multicenter Registry of KOrean PCI foR Endpoint Analysis registry were analyzed. The ADAPT scores, comprising the ischemic-ADAPT (I-ADAPT), bleeding-ADAPT (B-ADAPT), and Net-ADAPT scores, were calculated using clinical and angiographic parameters. Co-primary endpoints included ischemic outcomes (cardiovascular death, myocardial infarction, and stent thrombosis) and bleeding outcomes (major and minor bleeding). ResultsA total of 4,657 patients were included in analysis. The mean age was 63.8±11.1 years, and 72.3% were male. During a median follow-up of 368 days, ischemic outcomes occurred in 0.9% (43 patients), and bleeding outcomes in 0.9% (44 patients). The I-ADAPT and B-ADAPT scores had significant predictive values for ischemic outcomes (C-statistic=0.672; 95% confidence interval [CI], 0.585–0.758; p<0.001) and bleeding outcomes (C-statistic=0.715; 95% CI, 0.642–0.789; p<0.001), respectively. Regarding the Net-ADAPT score, patients with a score >0 were at a 1.7-fold higher risk of ischemic events, while those with a score of <0 had a 1.3-fold higher risk of bleeding events. ConclusionsThe ADAPT scores were validated for predicting ischemic and bleeding risks in patients receiving DAPT. This scoring system can aid in evaluating both ischemic and bleeding risks for East Asians, who exhibit unique risk profiles.
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