Healthcare & Clinical Calculators
PRECISE-DAPT Score (0–100): Post-PCI Bleeding Risk & DAPT Duration
Calculate Francesco Costa et al.’s (Lancet 2017) 5-item PRECISE-DAPT score (Hemoglobin, Age, WBC, CrCl, Prior Bleeding) to guide short (3–6 month, score >= 25) vs. standard/extended DAPT after coronary stenting.
ESC/ACC Class IIa decision support at the time of stent implantation—identifying PRECISE-DAPT >= 25 high bleeders!
Whereas the Yeh DAPT score is calculated AFTER 12 uneventful months of dual antiplatelet therapy, Francesco Costa et al. (The Lancet, 2017; n = 14,963 stented PCI patients across 8 randomized trials) developed PRECISE-DAPT for decision-making AT THE TIME OF CORONARY STENTING! Five bounded clinical predictors sum onto a 0–100 nomogram scale: Hemoglobin clamped to [10, 12] g/dL (7.5 * (12 - Hb), max 15 pts), Age clamped to [50, 90] years (0.475 * (Age - 50), max 19 pts), WBC clamped to [5, 20] × 10^9/L (1.0 * (WBC - 5), max 15 pts), CrCl clamped to [0, 100] mL/min (0.25 * (100 - CrCl), max 25 pts), and Prior Spontaneous Bleeding (+26 pts)!
In randomized validation, patients with PRECISE-DAPT >= 25 suffered excess TIMI major/minor bleeding on 12–24 month DAPT with zero ischemic benefit—favoring shortened 3–6 month DAPT—whereas scores < 25 derived net ischemic protection from standard 12-month DAPT!
| Post-PCI Clinical Profile | PRECISE-DAPT Score | Bleeding Risk Tier | ESC / Lancet 2017 DAPT Guidance |
|---|---|---|---|
| Hb 13.5, Age 58, WBC 6.5, CrCl 88, No Bleed | 8 pts (< 25) | Low / Moderate Bleeding Risk | Standard / Prolonged DAPT (12–24 mo) |
| Hb 10.8, Age 74, WBC 9.5, CrCl 52, No Bleed | 37 pts (>= 25) | High Bleeding Risk (PRECISE-DAPT >= 25) | Shortened DAPT (3–6 mo CCS / 1–6 mo ACS) |
| Invalid Hb <= 0, Age < 18, or Bleed > 1 | Error Guard | "Invalid Clinical Inputs" | Input Validation Guard |
PRECISE-DAPT 5-Variable Nomogram Score (0–100 Points)
Applies the published clamped linear point functions across Hemoglobin B2 (g/dL), Age B3 (years), WBC B4 (× 10^9/L), CrCl B5 (mL/min), and Prior Bleeding B6 (0/1).
=IF(OR(B2 <= 0, B3 < 18, B4 <= 0, B5 < 0, B6 < 0, B6 > 1), "Invalid Clinical Inputs", ROUND(7.5 * (12 - MIN(MAX(B2, 10), 12)) + 0.475 * (MIN(MAX(B3, 50), 90) - 50) + 1.0 * (MIN(MAX(B4, 5), 20) - 5) + 0.25 * (100 - MIN(MAX(B5, 0), 100)) + 26 * B6, 0))PRECISE-DAPT >= 25 Antiplatelet Duration Recommendation
Flags High Bleeding Risk (>= 25) vs. Non-High Bleeding Risk (< 25).
=IF(OR(B2 <= 0, B3 < 18, B4 <= 0, B5 < 0, B6 < 0, B6 > 1), "Invalid Clinical Inputs", IF(ROUND(7.5 * (12 - MIN(MAX(B2, 10), 12)) + 0.475 * (MIN(MAX(B3, 50), 90) - 50) + 1.0 * (MIN(MAX(B4, 5), 20) - 5) + 0.25 * (100 - MIN(MAX(B5, 0), 100)) + 26 * B6, 0) >= 25, "High Bleeding Risk (>= 25 — Consider Short 3–6m DAPT)", "Standard / Low Bleeding Risk (< 25 — 12m DAPT Eligible)"))Try the example
Use the original values or change them to test your understanding.