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Sun C, Zhong L, Wu Y, Cao C, Guo D, Liu J, Gong L, Zhang S, Sun J, Yu Y, Tong W, Yang J. Incorporation of Laboratory Test Biomarkers Into Dual Antiplatelet Therapy Score Improves Prediction of Ischemic and Bleeding Events in Post-percutaneous Coronary Intervention Patients. Front Cardiovasc Med 2022; 9:834975. [PMID: 35651911 PMCID: PMC9148992 DOI: 10.3389/fcvm.2022.834975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
This study aimed to examine the performance of the dual antiplatelet therapy (DAPT) score in two retrospective cohorts of post-percutaneous coronary intervention (PCI) patients and to explore whether incorporating additional biomarkers could further improve the predictive power of the DAPT score. In a retrospective derivation cohort of 4,798 PCI patients, the validity of DAPT score for stratifying ischemic/bleeding risks was explored. Then, the association between the baseline status of 54 laboratory test biomarkers and ischemic/bleeding events was revealed while adjusting for the DAPT score. Combinations of individual laboratory test biomarkers that were significantly associated with ischemic/bleeding events were explored to identify the ones that improved discrimination of ischemic and bleeding events when incorporated into DAPT score. Finally, the impact of the combination of biomarkers with DAPT score was validated in an independent retrospective validation cohort of 1,916 PCI patients. Patients with a high DAPT score (DAPT score ≥ 2) had significantly higher risk of ischemic events and significantly lower risk of bleeding than patients with a low DAPT score (DAPT score < 2). Moreover, the addition of aspartate aminotransferase (AST) and red cell distribution width CV (RDW-CV) into the DAPT score further improved discrimination of ischemia and bleeding. Furthermore, the incremental predictive value of AST + RDW-CV maintained with measurements was updated at post-baseline time points. DAPT score successfully stratified the risks of ischemia/bleeding post PCI in the current cohorts. Incorporation of AST + RDW-CV into the DAPT score further improved prediction for both ischemic and bleeding events.
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Affiliation(s)
- Chengming Sun
- Department of Clinical Laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Lin Zhong
- Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yanqiu Wu
- Medical Information Center, Peking University People’s Hospital, Beijing, China
| | - Chengfu Cao
- Department of Cardiology, Peking University People’s Hospital, Beijing, China
| | - Danjie Guo
- Department of Cardiology, Peking University People’s Hospital, Beijing, China
| | - Jie Liu
- Biochip Laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Lei Gong
- Biochip Laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Shouxin Zhang
- Biochip Laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Jun Sun
- Biochip Laboratory, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yingqi Yu
- Gennlife (Beijing) Technology Co., Ltd., Beijing, China
| | - Weiwei Tong
- Gennlife (Beijing) Technology Co., Ltd., Beijing, China
- *Correspondence: Weiwei Tong,
| | - Jun Yang
- Department of Cardiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- Jun Yang,
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