Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score.
D, C., A, O., R, M., S, S., Y, F., F, G., D, v.K., DJ, A., S, B., & DL, B. (2026). Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score.. JACC. Cardiovascular interventions. https://doi.org/10.1016/j.jcin.2026.04.051
D C, A O, R M, S S, Y F, F G, et al. Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score.. JACC. Cardiovascular interventions. 2026; doi: 10.1016/j.jcin.2026.04.051
D C, A O, R M, et al. Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score.[J]. JACC. Cardiovascular interventions. 2026. DOI: 10.1016/j.jcin.2026.04.051.
@article{d2026,
author = {Cao D and Oliva A and Mehran R and Sartori S and Feng Y and Gragnano F and van Klaveren D and Angiolillo DJ and Bangalore S and Bhatt DL},
title = {Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score.},
journal = {JACC. Cardiovascular interventions},
year = {2026},
doi = {10.1016/j.jcin.2026.04.051},
note = {PMID: 42442892},
}
TY - JOUR AU - Cao D AU - Oliva A AU - Mehran R AU - Sartori S AU - Feng Y AU - Gragnano F AU - van Klaveren D AU - Angiolillo DJ AU - Bangalore S AU - Bhatt DL TI - Abbreviated DAPT Regimens Across the Entire Spectrum of Bleeding Risk According to the PRECISE-HBR Score. T2 - JACC. Cardiovascular interventions PY - 2026 DO - 10.1016/j.jcin.2026.04.051 AN - PMID:42442892 ER -
BACKGROUND: Among high-bleeding risk (HBR) patients undergoing coronary stenting, abbreviated dual antiplatelet therapy (DAPT) reduces bleeding without ischemic risk trade-off; whether these benefits persist across the entire spectrum of bleeding risk has not been investigated. OBJECTIVES: The aim of this study is to explore the value of the novel PRECISE-HBR score as a risk stratification tool to guide DAPT duration in patients at high bleeding risk. METHODS: The XIENCE Short DAPT program combined 3 international single-arm studies of HBR patients treated with cobalt-chromium everolimus-eluting stents who discontinued DAPT at 1 month (XIENCE 28 USA/Global) or 3 months (XIENCE 90), if event free and treatment adherent. Bleeding risk was classified as nonhigh (PRECISE-HBR score ≤22), high (score 23-26), or very high (score ≥27). Clinical outcomes were assessed between 1 and 12 months using propensity score stratification. RESULTS: Among 3,364 patients, the PRECISE-HBR score was ≤22, 23-26, and ≥27 in 359 (10.7%), 744 (22.1%), and 2,261 (67.2%), respectively. Rates of BARC (Bleeding Academic Research Consortium) type 3-5 bleeding (0.3%, 2.5%, 5.6%) and death or myocardial infarction (2.9%, 4.6%, 9.8%) increased progressively across risk categories. One- versus 3-month DAPT was associated with a significant reduction in BARC type 3-5 bleeding in patients with a score ≥27 (HR: 0.59, 95% CI: 0.39-0.88) but not in those <27 (HR: 2.31, 95% CI: 0.89-5.99; P-interaction = 0.012). Ischemic risk was similar between 1- and 3-month DAPT, irrespective of the PRECISE-HBR score (P-interaction = 0.40). CONCLUSIONS: The PRECISE-HBR score identified patients at increased risk for both bleeding and ischemic events who seemed to derive greater benefit from 1-month DAPT after stent implantation.