TCT-546 Performance of the Dual AntiPlatelet Therapy (DAPT) Score in the ADAPT-DES Study.

Background The optimal duration of dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) remains in dispute, particularly after 12 months. The DAPT Score was developed from the DAPT trial to identify pts who may benefit the most from extended therapy. We sought to assess the performance of the DAPT risk score in the all-comers Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents (ADAPT-DES) registry, and to test the utility of additional predictors of events on its performance. Methods Patients free from ischemic or hemorrhagic events after 1 year of DAPT after successful DES implantation were analyzed. The DAPT score was calculated for each pt and outcomes between 1 and 2 years were examined according to the DAPT trial median score (≥2 vs. Results Among 8,582 pts in ADAPT-DES, 5,397 were event-free after 1 year, 3617 (67.0%) of whom remained on DAPT. Between 1 and 2 years, ischemic and hemorrhagic events occurred in 413 and 124 pts, respectively. Pts with higher vs. lower DAPT scores (≥2 vs. Conclusion In the in the ADAPT-DES registry, the DAPT score was reasonably predictive for ischemic events between 1 and 2 years after PCI, but was not useful to predict bleeding events. Prediction of bleeding can be significantly improved by addition of variables not incorporated in the DAPT score