DAPT Score

What This Calculator Measures

Determines whether the net benefit of continuing dual antiplatelet therapy (DAPT) beyond 12 months after coronary stenting outweighs the bleeding risk, guiding DAPT duration decisions.

How to Use

1. Confirm the patient has completed 12 months of DAPT after coronary stenting and is being considered for continued treatment.
2. Assign points for age, smoking, diabetes, MI at presentation, prior MI/PCI, small stent diameter, paclitaxel-eluting stent, CHF/LVEF <30%, and saphenous vein graft PCI.
3. Sum the points (−2 to +10).
4. Scores ≥2 favor extended DAPT; scores <2 favor stopping at 12 months.

Interpretation Guide

Score ≥2: net benefit of extended DAPT (up to 30 months) — ischemic reduction outweighs bleeding risk. Score <2: bleeding risk outweighs ischemic benefit — standard 12-month DAPT is preferred.

Clinical Significance

The DAPT score operationalizes the trade-off between stent ischemia and major bleeding, supporting individualized, evidence-based DAPT duration decisions after stenting.

When to Use

• Deciding whether to continue DAPT beyond 12 months after DES implantation
• Shared decision-making about DAPT duration after PCI
• Risk-benefit discussion balancing stent ischemia against major bleeding

When Not to Use

• Patients with high-risk ischemic indications where extended DAPT is mandated regardless of score
• As a substitute for bleeding risk assessment in patients with active bleeding or high-risk anatomy

Limitations

• Derived from the DAPT Study, which used specific antiplatelet regimens and stents; applicability to contemporary stents and P2Y12 inhibitors varies.
• Does not account for all bleeding risk factors (e.g., renal function, baseline anemia).
• The 2-point threshold is derived, not head-to-head validated across all populations.

Worked Example

A 60-year-old current smoker underwent PCI with a 2.75 mm DES for an NSTEMI, with a history of a prior PCI. No diabetes, no CHF, no SVG graft, and no paclitaxel stent.

DAPT score 4 — favors EXTENDED dual antiplatelet therapy beyond 12 months. Expected ischemic reduction outweighs bleeding risk.

Evidence

Source

Cardiology Literature

Reference

Yeh RW, et al. JAMA. 2016;315(16):1735-1749.

Reviewed By

MedCalcHub Clinical Team

Version

2016

Updated

2026-08

1. Yeh RW, et al. JAMA. 2016;315(16):1735-1749.

References

1. Yeh RW, et al. Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention. JAMA. 2016;315(16):1735-1749. (Level II)