Consecutive or selectively included high bleeding risk patients in the MASTER DAPT screening log and trial

LANDI, Antonio, Dik HEG, Enrico FRIGOLI, Pim A L TONINO, Pascal VRANCKX, Suzanne POURBAIX, Bernard CHEVALIER, Andres INIGUEZ, Eduardo PINAR, Maciej LESIAK, Petr KALA, Michael DONAHUE, Stephan WINDECKER, Marco ROFFI, Pieter C SMITS and Marco VALGIMIGLI. Consecutive or selectively included high bleeding risk patients in the MASTER DAPT screening log and trial. European Journal of Internal Medicine. AMSTERDAM: ELSEVIER, 2024, vol. 126, August 2024, p. 89-94. ISSN 0953-6205. Available from: https://dx.doi.org/10.1016/j.ejim.2024.04.016.

Basic information

• Original name: Consecutive or selectively included high bleeding risk patients in the MASTER DAPT screening log and trial
• Authors: LANDI, Antonio, Dik HEG, Enrico FRIGOLI, Pim A L TONINO, Pascal VRANCKX, Suzanne POURBAIX, Bernard CHEVALIER, Andres INIGUEZ, Eduardo PINAR, Maciej LESIAK, Petr KALA (203 Czech Republic, belonging to the institution), Michael DONAHUE, Stephan WINDECKER, Marco ROFFI, Pieter C SMITS and Marco VALGIMIGLI.
• Edition: European Journal of Internal Medicine, AMSTERDAM, ELSEVIER, 2024, 0953-6205.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30201 Cardiac and Cardiovascular systems
• Country of publisher: Netherlands
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 8.000 in 2022
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.ejim.2024.04.016
• UT WoS: 001287622700001
• Keywords in English: High bleeding risk; Antiplatelet therapy; Dual antiplatelet therapy; Percutaneous coronary intervention
• Tags: 14110211, rivok
• Tags: International impact, Reviewed

Abstract

Aims: Screening logs have the potential to appraise the actual prevalence and distribution of predefined patient subsets, avoiding selection biases, which are inevitably and potentially present in randomised trials and real- world registries, respectively. We aimed to assess the prevalence of high bleeding risk (HBR) characteristics in the real world and the external validity of the MASTER DAPT trial. Methods and results: All consecutive patients who underwent percutaneous coronary intervention (PCI) for at least two consecutive weeks across 65 sites participating in the trial were entered into a screening log. Of 2,847 consecutive patients, 1,098 (38.6 %) were HBR and 109 (9.9 %) consented for trial participation. PRECISE-DAPT score > 25 was the most frequent HBR feature, followed by advanced age, use of oral anticoagulation (OAC) and anaemia. Compared with consecutive HBR patients, consenting patients were older (> > 75 years: 69 % versus 62 %, absolute standardized difference [SD] 0.16), more frequently male (78 % versus 71 %, absolute SD 0.18), had higher use of OAC (38 % versus 20 %, absolute SD 0.39), treatment with steroids or nonsteroidal antiinflammatory drugs (10 % versus 5 %, SD 0.16), and prior cerebrovascular events (10 % versus 6 %, , absolute SD 0.18) but lower PRECISE DAPT score > 25 (54 % versus 66 %, absolute SD 0.24). Conclusions: The HBR criteria distribution differed between consecutive versus selectively included HBR patients, suggesting the existence of selection biases in the trial population.