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DAPT score: predictive model of dual-antiplatelet therapy for acute cerebral infarction

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Abstract

Objective

This article analyzes factors which affect the prognosis of acute cerebral infarction (ACI) patients receiving a course of antiplatelet therapy with aspirin and (or) clopidogrel for 14 days and proposes a simple grading scale to predict the clinical effectiveness of these drugs.

Methods

We evaluated the association between ACI and risk factor (univariate analysis) on at day 14 post admission. Factors which potentially affected the 14-day prognosis of the patients were identified by logistic regression. A clinical grading scale, the DAPT score, was developed by weighing the independent predictors based on these factors.

Results

It is revealed that the factors which affected 14 days prognosis univariate analysis included age ≥ 50 years (P = 0.007), diabetes (P = 0.017), hypertension (P ≤ 0.001), hyperhomocysteinemia (P = 0.001), and ipsilateral carotid artery stenosis ≥ 50% (P = 0.019). Logistic regression also revealed that the factors which affected 14 days prognosis included age ≥ 50 years (P = 0.007), hypertension (P ≤ 0.001), hyperhomocysteinemia (P = 0.001), and ipsilateral carotid artery stenosis ≥ 50% (P = 0.014).The assigned values of age ≥ 50 years, Grade 1 hypertension, Grade 2 hypertension, Grade 3 hypertension, hyperhomocysteinemia, and ipsilateral carotid artery stenosis ≥ 50% were 1, 1, 2, 3, 1, and 1, respectively. We named this score (DAPT score) and it ranged between 0 and 6. Using 3 as a cutoff, the sensitivity was 90.6% and the specificity was 63.3%.

Conclusions

The DAPT Score might be useful to for identifying with ACI who are suitable to receive aspirin combined with clopidogrel. Future large-scale, multi-center prospective studies are necessary.

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Acknowledgments

Thanks for the guidance from Prof. Jianxiong Liu from the Gansu Provincial People’s Hospital.

Funding

This work is supported by the Key Laboratory of Evidence Based Medicine and KnowledgeTranslation Foundation of Gansu Province (Grant no. GSXZYZH2018006). Laboratory of Intelligent medical engineering of Gansu Province (Grant no. GSXZYZH2018001).

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Author notes

  1. Yang Liu, Jia Yang and Panpan Jiang contributed equally to this work.

Authors and Affiliations

  1. Ningxia Medical University, Yinchuan, 750004, China

    Yang Liu, Jia Yang, Panpan Jiang & Mayan Wang

  2. Gansu Provincial Hospital, 204 West Donggang R.D, Lanzhou, 730000, China

    Yang Liu, Jia Yang, Panpan Jiang, Mingming Wang, Mayan Wang, Tiankang Guo & Jianxiong Liu

  3. Gansu Province Hospital Rehabilitation Center, Lanzhou, 730000, China

    Shan Wang

Authors
  1. Yang Liu
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  2. Jia Yang
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  3. Panpan Jiang
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  4. Shan Wang
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  5. Mingming Wang
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  6. Mayan Wang
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  8. Jianxiong Liu
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Corresponding authors

Correspondence to Tiankang Guo or Jianxiong Liu.

Ethics declarations

The study has been approved by the ethics committee of the Ningxia Medical University and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Details that might disclose the identity of the subjects under study have been omitted before the analysis. All recruited persons gave their informed consent prior to their inclusion in the study.

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The authors declare that they have no conflicts of interest.

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Informed consent was obtained from all individual participants included in the study.

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Cite this article

Liu, Y., Yang, J., Jiang, P. et al. DAPT score: predictive model of dual-antiplatelet therapy for acute cerebral infarction. Neurol Sci 42, 681–688 (2021). https://doi.org/10.1007/s10072-020-04552-w

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  • DOI: https://doi.org/10.1007/s10072-020-04552-w

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