DAPT Calculator

The DAPT Score is a validated clinical tool used to determine whether a patient who has undergone coronary drug-eluting stent placement should continue dual antiplatelet therapy (aspirin + a P2Y12 inhibitor) beyond 12 months. A score ≥ 2 suggests ischemic benefit outweighs bleeding risk, while a score < 2 suggests prolonged therapy may increase bleeding without meaningful ischemic benefit.

The score sums points from nine clinical variables: age (−2 to +2), cigarette smoking (+1), diabetes (+1), MI at presentation (+1), prior PCI or MI (+1), paclitaxel-eluting stent (+1), stent diameter < 3 mm (+1), CHF or LVEF < 30% (+2), and saphenous vein graft stent (+2). The total ranges from −2 to +10.

A score of 2 or higher indicates that prolonged DAPT (beyond 12 months) is associated with a net clinical benefit — specifically, a reduction in myocardial infarction and stent thrombosis that outweighs the incremental bleeding risk. Extended therapy is generally recommended for these patients if they are not at high risk of bleeding.

A score below 2 indicates that the ischemic benefit of prolonged DAPT is unlikely to outweigh the bleeding risk. In these patients, discontinuing the P2Y12 inhibitor after 12 months is typically recommended. Clinical judgment and patient preferences should always be incorporated.

The DAPT Score was derived and validated from the landmark DAPT Study, a large randomized controlled trial enrolling over 11,000 patients who had drug-eluting stents placed and remained event-free on dual antiplatelet therapy for 12 months. The scoring algorithm was published in JAMA in 2016 by Yeh et al.

The score is intended only for patients who have completed 12 months of DAPT after drug-eluting stent implantation without a major adverse cardiac event or significant bleeding. It should not be used in patients with bare-metal stents, those who had an event during the initial 12 months, or those on oral anticoagulation therapy.

No. The DAPT Score is a decision-support tool to supplement, not replace, individualized clinical assessment. Factors such as concomitant oral anticoagulation, active bleeding history, patient adherence, and patient preferences must be considered alongside the score when making treatment decisions.

The DAPT Score predicts net clinical benefit of prolonged DAPT from an ischemic risk perspective (derived from patients already on 12 months of DAPT). The PRECISE-DAPT Score, in contrast, is designed to estimate out-of-hospital bleeding risk at the time of PCI and is used to guide the initial DAPT duration decision (short vs. standard vs. long course).