Comparison of predictive value of risk scores for gastrointestinal bleeding in antiplatelet therapy

Abstract

Gastrointestinal bleeding (GIB) is the most common serious bleeding complication of antiplatelet therapy. The bleeding risk score (BRS) of GIB may help to determine the risk of bleeding, and provides a reference for the formulation of antiplatelet therapy regimen in clinical practice, but we found that no specific risk scores are available in East Asian patients. This study analyzed patients who were administered antiplatelet therapy from May 2015 to December 2018 in two medical centers. Patient’s baseline data were obtained. We assessed four BRSs (New Score, RIETE Score, Cuschieri Score, de Groot Score) and compared them using the area under the receiver operating characteristic curve (AUC). The 4,052 patients enrolled in this study had an average age of 69.6 ± 10.8 years, and 65.9% of them were male. Among the 4,052 patients included, 171 patients experienced GIB within 6 months of follow-up. In the study population, the AUCs for the New, RIETE, Cuschieri, and de Groot scores were 0.673 (95% confidence interval (CI) 0.616–0.729, P < .001), 0.742 (95% CI 0.690–0.794, P < .001), 0.598 (95% CI 0.537–0.659, P = .002), and 0.875 (95% CI 0.839–0.912, P < .001), respectively. After validation, the de Groot Score has better performance. Among the four scores, the de Groot Score might be more suitable for helping Chinese clinicians to predict the risk of GIB in patients taking antiplatelet drugs, and reduce GIB events.

Keywords:

• Platelet aggregation inhibitors
• Predictive factor
• Gastrointestinal bleeding
• Scores
• Risk assessment

Author contributions

JZ initiated the study. ML and XZ performed the data extraction and analyses. ML drafted the first version of the manuscript. JZ and ML critically reviewed the manuscript and revised it. All authors made a substantial contribution to the concept and design of the study, interpreted the data, and reviewed the manuscript.

Disclosure statement

The authors declare that they have no conflicts of interest.

Additional information

Funding

This work was supported by the [Natural Science Foundation of Fujian Province of China] under Grant [number 2018Y0037];Natural Science Foundation of Fujian Province, China [2018Y0037];