Evaluation of SAMe-TT2R2 risk score for predicting the quality of anticoagulation control in a real-world cohort of patients with non-valvular atrial fibrillation on vitamin-K antagonists.

Autor:	Abumuaileq RR; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain drrami2012@hotmail.com., Abu-Assi E; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., Raposeiras-Roubin S; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., López-López A; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., Redondo-Diéguez A; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., Álvarez-Iglesias D; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., Rodríguez-Mañero M; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., Peña-Gil C; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain., González-Juanatey JR; Cardiology Department, Hospital Clínico Universitario de Santiago de Compostela, A choupana s/n, Santiago de Compostela 15706, Spain.
Jazyk:	angličtina
Zdroj:	Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology [Europace] 2015 May; Vol. 17 (5), pp. 711-7. Date of Electronic Publication: 2015 Feb 05.
DOI:	10.1093/europace/euu353
Abstrakt:	Aims: Clinicians need to get better at identifying patients who would have poor quality of anticoagulation control with vitamin-K antagonists (VKAs). We assessed the predictive ability of SAMe-TT2R2 score, recently conceived for the prior purpose, and examined its relationship with major bleeding, thromboembolic (TE) complications, and death. Methods and Results: Retrospectively, 911 consecutive patients with non-valvular atrial fibrillation (NVAF) started on VKAs within 8 months were studied. The percentage of international normalized ratios in therapeutic range (PINRR) at different levels was used as a metric of anticoagulation quality. We also tested the SAMe-TT2R2 predictability for major bleeding, TE complications, and death throughout 10 ± 3 months. The PINRR decreased from 62% at zero point to 53% at ≥4 points of SAMe-TT2R2. 82.1% of patients who achieved PINRR ≥ 70% had 0 or 1 point of SAMe-TT2R2. SAMe-TT2R2 performed significantly better at PINRR 70% than at 65 and 60% (c-statistic = 0.60 vs. c-statistic = 0.56). The calibration of SAMe-TT2R2 was excellent (Hosmer-Lemeshow test P-values ≥ 0.6). SAMe-TT2R2 showed significant association with the composite outcome of major bleeding, TE complications, and death [n = 98; hazard ratio (HR) = 1.32; 95% confidence interval (CI) 1.08-1.60]; the c-statistic was 0.57 (95% CI: 0.51-0.62) and P = 0.03. As individual outcomes, SAMe-TT2R2 was significantly associated with death (n = 60; HR = 1.3; 95% CI: 1.03-1.69), but not with either major bleeding (n = 30; HR = 1.2; 95% CI: 0.85-1.76) or TE complications (n = 15; HR = 1.01; 95% CI: 0.58-1.77). Conclusion: Among NVAF patients, SAMe-TT2R2 could represent a useful clinical tool to identify patients who would have poor quality of anticoagulation control with VKAs. SAMe-TT2R2 successfully predicts the composite outcome of major bleeding, TE complications, and death. (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu