DAPT Calculator
Assess optimal duration of dual antiplatelet therapy after PCI
DAPT Risk Assessment
Older age increases bleeding risk: 65-74 years (-1 point), ≥75 years (-2 points)
Diabetes mellitus increases thrombotic risk
Previous PCI or MI indicates higher baseline cardiovascular risk
MI at presentation suggests acute coronary syndrome with higher thrombotic risk
Small stent diameter (<3mm) associated with higher restenosis risk
Vein graft interventions have higher rates of thrombotic complications (2 points)
Heart failure or LVEF <30% indicates poor cardiac function (2 points)
Current or past smoking increases both thrombotic and bleeding risks
Paclitaxel-eluting stents may have different thrombotic profiles
DAPT Score Results
Aspirin monotherapy should be more beneficial than prolonged DAPT
Recommendation: Aspirin alone may be preferred
Risk Balance: Bleeding risk may outweigh ischemic benefit
Score Breakdown
• No risk factors selected
Example Assessment
Patient Example
Patient: 58-year-old male with recent STEMI
Medical History: Diabetes, prior MI 3 years ago
Current PCI: Drug-eluting stent to LAD (3.5mm diameter)
Other factors: No CHF, no smoking, no vein graft intervention
Score Calculation
• Age <65 years: 0 points
• Diabetes mellitus: +1 point
• Prior MI: +1 point
• MI at presentation: +1 point
Total Score: 3 points
High Score: Prolonged DAPT recommended
Interpretation: Ischemic benefit outweighs bleeding risk
Score Interpretation
High Score (≥2 points)
Prolonged DAPT recommended
Ischemic benefit outweighs bleeding risk
Low Score (≤1 point)
Aspirin alone may be preferred
Bleeding risk may outweigh benefit
Scoring System
Clinical Context
For patients completing 1 year DAPT without events
Prolonged DAPT reduces stent thrombosis and MI
Prolonged DAPT increases bleeding risk
Based on DAPT trial (11,648 patients)
Medical Disclaimer
This calculator is for educational purposes only and should not replace professional medical advice. The DAPT score is a clinical decision support tool that must be interpreted by qualified healthcare professionals. Individual patient factors, bleeding risk, contraindications, and clinical judgment should always guide antiplatelet therapy decisions. Always consult with a cardiologist or interventional cardiologist before modifying antiplatelet therapy regimens.
Understanding DAPT Score
What is DAPT?
Dual Antiplatelet Therapy (DAPT) combines aspirin with a P2Y12 inhibitor (like clopidogrel, prasugrel, or ticagrelor). It's used after percutaneous coronary intervention (PCI) with stent placement to prevent stent thrombosis and reduce ischemic events.
When to Use DAPT Score
- •Patients who completed 1 year of DAPT without events
- •Decision to continue or discontinue DAPT
- •Balancing ischemic vs bleeding risk
- •Post-PCI with stent placement
Risk-Benefit Balance
Benefits of Prolonged DAPT
- • Reduces stent thrombosis risk
- • Decreases myocardial infarction
- • Prevents ischemic events
Risks of Prolonged DAPT
- • Increased bleeding risk
- • Major hemorrhage complications
- • Drug costs and adherence issues
Study Basis: DAPT trial with 11,648 randomized patients who completed 12 months of DAPT without major bleeding or ischemic events
Clinical Implementation
High Score (≥2 points)
- • Continue DAPT beyond 12 months
- • Ischemic benefit outweighs bleeding risk
- • Consider up to 30 months total duration
- • Monitor for bleeding complications
Low Score (≤1 point)
- • Consider discontinuing P2Y12 inhibitor
- • Continue aspirin monotherapy
- • Bleeding risk may outweigh benefit
- • Individual patient assessment crucial