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
| العنوان: | 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 |
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| المؤلفون: | Sergio Raposeiras-Roubín, Diego Álvarez-Iglesias, Emad Abu-Assi, Rami Riziq-Yousef Abumuaileq, José Ramón González-Juanatey, Carlos Peña-Gil, Andrea López-López, Moisés Rodríguez-Mañero, Alfredo Redondo-Diéguez |
| المصدر: | RUNA. Repositorio da Consellería de Sanidade e Sergas Servizo Galego de Saúde (SERGAS) |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Vitamin K, Non valvular atrial fibrillation, Hemorrhage, Vitamin k, Risk Assessment, Decision Support Techniques, Predictive Value of Tests, Risk Factors, Physiology (medical), Internal medicine, Thromboembolism, Atrial Fibrillation, Medicine, Humans, International Normalized Ratio, Blood Coagulation, Aged, Retrospective Studies, Aged, 80 and over, Framingham Risk Score, business.industry, Patient Selection, Hazard ratio, Anticoagulants, Atrial fibrillation, Middle Aged, medicine.disease, Confidence interval, Surgery, Stroke, Treatment Outcome, Cohort, Female, Drug Monitoring, Cardiology and Cardiovascular Medicine, business, Major bleeding |
| الوصف: | 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. |
| تدمد: | 1532-2092 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e9f5596b5d4db949c075b91c47f9b8c4Test https://pubmed.ncbi.nlm.nih.gov/25829474Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....e9f5596b5d4db949c075b91c47f9b8c4 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15322092 |
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