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.

中文翻译：

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DAPT评分：急性脑梗死双重抗血小板治疗的预测模型。

目的

本文分析了影响接受阿司匹林和（或）氯吡格雷抗血小板治疗疗程14天的急性脑梗死（ACI）患者预后的因素，并提出了一个简单的分级量表来预测这些药物的临床疗效。

方法

我们在入院后第14天评估了ACI与危险因素之间的关联（单因素分析）。通过逻辑回归确定可能影响患者14天预后的因素。通过根据这些因素对独立预测变量进行权衡，制定了临床分级量表（DAPT评分）。

结果

据透露，这影响14天预后单变量分析包括年龄≥50岁（因素P =  0.007），糖尿病（P =  0.017），高血压（P  ≤0.001），同型半胱氨酸血症（P =  0.001），和同侧的颈动脉狭窄≥50％（P =  0.019）。Logistic回归还透露，这影响14天预后包括年龄≥50岁（因素P =  0.007），高血压（P  ≤0.001），同型半胱氨酸血症（P =  0.001），和同侧的颈动脉狭窄≥50％（P = 0.014）。年龄≥50岁，1级高血压，2级高血压，3级高血压，高同型半胱氨酸血症和同侧颈动脉狭窄≥50％的分配值分别为1,1、2、3、1、1。我们将该分数命名为DAPT分数，范围在0到6之间。使用3作为截止值，灵敏度为90.6％，特异性为63.3％。

结论

DAPT分数可能有助于确定适合接受阿司匹林联合氯吡格雷治疗的ACI患者。将来需要进行大规模，多中心的前瞻性研究。