cliot (version 1.0.0)

dapt_score: Dual Antiplatelet Therapy (DAPT) Score

Description

Calculates the DAPT Score to guide the duration of dual antiplatelet therapy (DAPT) after coronary stent implantation. The score balances the risks of ischemia (stent thrombosis, MI) against the risks of bleeding to determine if prolonged therapy (>12 months) is beneficial.

Usage

dapt_score(age, smoker, diabetes, mi_presentation, prior_pci_mi,
           paclitaxel_stent, stent_diameter_lt_3mm, chf_lvef_lt_30,
           vein_graft_stent)

Value

A list containing:

DAPT_Score

The calculated score (Range -2 to 10).

Risk_Profile

"Low Score" (<2) or "High Score" (>=2).

Recommendation

Clinical guidance regarding DAPT duration (Standard vs. Prolonged).

Arguments

age

Numeric. Patient age in years. >= 75: -2 pts. 65-74: -1 pt. < 65: 0 pts.

smoker

Numeric (0 or 1). Current cigarette smoker. (1 = Yes, +1 pt).

diabetes

Numeric (0 or 1). Diabetes mellitus. (1 = Yes, +1 pt).

mi_presentation

Numeric (0 or 1). MI at presentation. (1 = Yes, +1 pt).

prior_pci_mi

Numeric (0 or 1). Prior PCI or prior MI. (1 = Yes, +1 pt).

paclitaxel_stent

Numeric (0 or 1). Paclitaxel-eluting stent used. (1 = Yes, +1 pt).

stent_diameter_lt_3mm

Numeric (0 or 1). Stent diameter < 3 mm. (1 = Yes, +1 pt).

chf_lvef_lt_30

Numeric (0 or 1). Congestive heart failure or LVEF < 30%. (1 = Yes, +2 pts).

vein_graft_stent

Numeric (0 or 1). Vein graft stent. (1 = Yes, +2 pts).

References

Yeh RW, Secemsky EA, Kereiakes DJ, et al. Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention. JAMA. 2016;315(16):1735-1749. doi:10.1001/jama.2016.3775

Examples

# Example 1: Prolonged DAPT Candidate
# 55yo (0), Smoker (+1), MI at presentation (+1), Diabetes (+1)
# Score = 3
dapt_score(55, 1, 1, 1, 0, 0, 0, 0, 0)

# Example 2: Standard DAPT Candidate
# 70yo (-1), Prior MI (+1), No other factors
# Score = 0
dapt_score(70, 0, 0, 0, 1, 0, 0, 0, 0)