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Dual Antiplatelet Therapy (DAPT) score for decision-making about the duration of dual antiplatelet therapy after coronary stenting, balancing ischemic benefit against bleeding risk (score −2 to +10).
Clinical decision-support tool for qualified healthcare professionals. Results are not a diagnosis and should not replace professional clinical judgment.
The DAPT score was derived from the DAPT Study to identify patients who derive net benefit from continuing DAPT beyond 12 months after coronary stenting. A score ≥2 favors extended DAPT (up to 30 months), while a score <2 favors standard 12-month therapy, balancing ischemic reduction against moderate/severe bleeding risk.
Specialty
CardiologyCategory
CardiologyDifficulty
Basic
Estimated Time
30 seconds
Version
1.0
Last Updated
2026-08-15
Formula
Keywords
Normal Range
−2 to +10 points
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.
The DAPT score starts with an age score (0 under 65, -1 for 65 to under 75, -2 for 75 or older), adds 1 point each for smoking, diabetes, MI at presentation, prior MI/PCI, stent diameter under 3 mm, and paclitaxel-eluting stent, and adds 2 points each for CHF or LVEF under 30% and saphenous vein graft PCI. A score of 2 or more favors extended dual antiplatelet therapy.
Age band, scored 0 (under 65), -1 (65 to under 75), or -2 (75 or older).
Current smoking; Yes adds 1 point.
Diabetes; Yes adds 1 point.
MI at presentation; Yes adds 1 point.
Prior MI or PCI; Yes adds 1 point.
Stent diameter under 3 mm; Yes adds 1 point.
Paclitaxel-eluting stent; Yes adds 1 point.
CHF or LVEF under 30%; Yes adds 2 points.
PCI of a saphenous vein graft; Yes adds 2 points.
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.
The DAPT score operationalizes the trade-off between stent ischemia and major bleeding, supporting individualized, evidence-based DAPT duration decisions after stenting.
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.
Inputs:
Expected Result: DAPT score 4 — favors EXTENDED dual antiplatelet therapy beyond 12 months. Expected ischemic reduction outweighs bleeding risk.
It estimates whether continuing dual antiplatelet therapy beyond 12 months after coronary stenting provides net benefit. A score of 2 or more favors extended DAPT up to 30 months because ischemic reduction is expected to outweigh bleeding risk, while a score below 2 favors standard 12-month therapy. It balances stent-related ischemic events against moderate or severe bleeding.
Age contributes negative points: 0 for under 65, -1 for 65 to under 75, and -2 for 75 or older, so the total ranges from -2 to +10. Advanced age carries a higher bleeding risk on prolonged dual antiplatelet therapy, so it reduces the net-benefit estimate and makes the 2-point threshold harder to reach. This reflects the trade-off the score was designed to capture.
The tool was developed in the DAPT Study, so its applicability to newer stents and P2Y12 inhibitors may differ. It omits some bleeding risk factors, including renal function and baseline anemia, and the 2-point cutoff was derived rather than compared head-to-head across all populations. Clinical judgment and individual bleeding risk still guide the final decision.
Disclaimer: This calculator is intended for educational and clinical decision support purposes only. DAPT duration decisions must incorporate stent type, ischemic risk, bleeding risk, and patient preferences.