Performance of Bleeding Risk Scores in Predicting Bleeding Complications in Korean Patients Who Are Receiving Dual Antiplatelet Therapy for Acute Coronary Syndrome

The current practice guideline recommends bleeding risk scores as risk-assessment tool for the management of patients with acute coronary syndrome (ACS) receiving dual antiplatelet therapy (DAPT), but no validated tool exists for Korean patients with a well-known differential propensity for bleeding and ischemic events.1,2 We sought to compare the predictive performance of commonly used bleeding risk scores of the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY),3 Patterns of Non-Adherence to Anti-Platelet Regimen in Stented Patients (PARIS),4 and Predicting Bleeding Complications in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (PRECISE-DAPT)5 risk scores for bleeding complications in Korean (Korean) patients with ACS receiving DAPT. [...]studies should be performed to develop race-specific risk score for prediction of bleeding and ischemic events.Disclosures The authors have no conflicts of interest to declare.Funding This work was supported by Chungnam National University Hospital (Daejeon, South Korea) Research Fund, 2020. ACUITY score PARIS score PRECISE-DAPT score Median (interquartile range) values Mean ± standard deviation 13.0 (8.0-18.0) 13.9±7.5 4.0 (3.0-6.0) 4.3±2.3 9.0 (5.0-15.0) 10.3±7.5 C-statistic (95% CI) 0.651 (0.617-0.684) 0.584 (0.548-0.618) 0.575 (0.540-0.610) HL goodness-of-fit test (χ2 [p value]) 5.809 (0.669) 5.1715 (0.456) 7.035 (0.533) Pairwise comparison of the C-statistic (Z statistics [p value]) ACUITY vs PARIS ACUITY vs PRECISE-DAPT PRECISE-DAPT vs PARIS 1.962 (0.0498) 2.155 (0.0312) 0.240 (0.8101) Table 1 Prognostic accuracy of 3 risk scores for major or minor bleeding according to the PLATO criteria