The DAPT calculator assesses the risk of ischemia and bleeding in patients with a dual antiplatelet therapy treatment plan after percutaneous coronary intervention. Platelets are the primary cells that control internal or external bleeding in any person. Antiplatelet therapy will surely increase the bleeding risk in the patient undergoing this treatment plan.
The DAPT calculator is not a replacement for clinical diagnosis but helps in the assessment of bleeding and ischemia. This DAPT calculator performs outstandingly in a population of high ischemic and low bleeding risk. This article explains a wide range of details and the usage of the DAPT calculator. In addition, it will also help you regarding the usage of the DAPT calculator.
What is dual antiplatelet therapy?
As we discussed earlier, platelets are the units of blood that combine together to form a blood clot at the site of bleeding. This blood clot prevents further bleeding and, indirectly, the loss of blood. In this way, platelets are the integral component for maintaining normal healthy activities in the body. There are several medical conditions associated with the platelets, like disturbed platelet count or structural abnormalities. These anomalies may cause clotting in the coronary stent, leading to a sudden heart attack.
Antiplatelet therapy belongs to the pharmaceutical category that prevents the platelets from combining together to form a clot. Antiplatelet therapy is indicated for patients who have a previous history of stroke or myocardial infarction. In addition, this antiplatelet therapy is also indicated as a prophylaxis to prevent the incidence of stroke or myocardial infarction. Dual antiplatelet therapy includes a combination of aspirin and P2Y12 inhibitors like thienopyridine.
Dual antiplatelet therapy is prescribed to patients who have undergone coronary artery bypass graft surgery, have stents in the coronary artery, or survived a heart attack. This therapy acts as an additional protective barrier to heart-related problems.
What is the dual antiplatelet therapy (DAPT) score?
The DAPT calculator is the abbreviation of the dual antiplatelet therapy calculator. The DAPT score indicates the optimum time limit for antiplatelet therapy after the percutaneous coronary artery intervention (PCI) with the stents in the coronary artery. It is stated that people taking antiplatelet therapy after PCI for 1 year have a decreased incidence of stent thrombosis or myocardial infarction. In contrast to the benefit, it increases the chances of bleeding due to antiplatelet therapy.
The intake of dual antiplatelet therapy requires a proper assessment and management before the continuation of treatment. The DAPT score was obtained after a randomized trial study. In this study, random patients were taken to continue dual antiplatelet therapy versus placebo. The arbitrary patients were taken only if they had no previous history of heart attack, stroke, repeated revascularization, bleeding, or stent thrombosis, and remained adherent to the medication for the first year. The DAPT score has 9 main findings.
- Age of the patient – if the age is less than 65 years, 0 points will be added. If the age ranges between 65 to 75 years, -1 point will be added to the overall score. If the age of the patient is 75 or more 75, -2 points will add to the original score.
- If the patient is suffering from diabetes mellitus, 1 point will be added to the DAPT score.
- If the patient has a previous history of myocardial infarction or percutaneous coronary artery intervention, we will add 1 point to the original DAPT score.
- If the patient is having myocardial infarction at presentation, we will add one point to the DAPT score.
- If the coronary stent diameter is less than 3mm, we’ll add 1 point to the DAPT score.
- If the patient is having a vein graft stent, we will add 1 point to the DAPT score.
- If the patient has a History it congestive heart failure or left ventricular ejection fraction < 30%, we will add 2 points to the original DAPT score.
- If the patient is a current smoker or has been smoking within the past year, we will add 1 point to the score.
- If the patient has a paclitaxel-eluting stent intervention, we will add one point to the DAPT score.
The DAPT score can vary from -2 to 10 points. There are two basic interpretations. That is as follows:
- If the DAPT score is 2 or more than 2 points, the doctors consider adding other dual antiplatelet medications other than aspirin.
- If the DAPT score is 1 or less than 1, only aspirin can benefit the patient after percutaneous coronary artery intervention with stents.
How can we use the DAPT calculator?
The DAPT calculator is easy to use and provides results only based on the patient’s history. Add the history in point form. Conclude the result by only adding these points.
- Confirm the age factor of the patient.
- Add the points by concluding the history questions in the form of yes or no.
- Confirm the result either is it less than 2 points or greater than 2 points.
The DAPT calculator is the abbreviation of a dual antiplatelet therapy calculator. It is an important tool to evaluate the need for antiplatelet therapy for patients with coronary artery stents. Antiplatelet therapy increases the bleeding risk in patients. So it requires proper assessment and management before the start of dual antiplatelet therapy. Following the basic parameters of the DAPT calculator, it becomes easy to extract such patients who require dual antiplatelet therapy.
The DAPT calculator also depends on the age of the patient. It also requires a proper history of myocardial infarction or any previous stroke presentation. Moreover, a smoking history is also necessary. These are the risk factors for stent thrombosis. For this reason, these risk factors add points to the DAPT score to evaluate the need for antiplatelet therapy.
Frequently asked questions (FAQs)
What is the minimum time duration for the intake of dual antiplatelet therapy?
For patients suffering from acute coronary syndrome, it is recommended to take antiplatelet therapy for about 12 months. But in contrast to patients having bleeding risk, it is recommended to take antiplatelet therapy for about 6 months.
When is there a need to use a DAPT calculator?
The DAPT calculator is usually used to assess the antiplatelet therapy duration with proper clinical examination and the patient’s health.