Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients with venous thromboembolism treated with vitamin K antagonists: Findings from the RIETE registry

Del-Toro-Cervera, Jorge; Demelo‐Rodríguez, Pablo; Galeano‐Valle, Francisco; Fidalgo, Ángeles; Sampériz, A.; Muñoz-Torrero, Juan Francisco Sánchez; Lima, Jorge Roberto Perrout de; Sigüenza, Patricia; Tufano, Antonella; Monreal, Manuel; Investigators, Riete

doi:10.1016/j.thromres.2020.06.022

Cited by 5 publications

(8 citation statements)

References 26 publications

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“…Therefore, our findings should be interpreted in the context that most participants were men and attested in more representative population. Fourth, although the SAMe-TT2R2 score is a simple score based on clinical risk factors (sex, age, medical history, treatment [interacting drugs, e.g., amiodarone for rhythm control], tobacco and race), to distinguish patients according to low or high probability of poor INR control (TTR <65%) [ 23 ], we were unable to calculate SAMe-TT2R2 score in this study because details of treatments were lacking. Fifth, we did not incorporate the change in OACs during the follow-up.…”

Section: Discussionmentioning

confidence: 99%

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Arai

Ueda

Uchida

et al. 2022

International Journal of Cardiology Cardiovascular Risk and Pre

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Section: Discussionmentioning

confidence: 99%

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Arai

Ueda

Uchida

et al. 2022

International Journal of Cardiology Cardiovascular Risk and Pre

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“…Nuestros hallazgos coinciden con otras publicaciones relativas a este efecto secundario derivado del tratamiento con AVK. 10,25 En líneas generales, estos resultados ponen de manifiesto la necesidad de buscar mejores y más seguras alternativas terapéuticas en pacientes con TEV con un RTA bajo en lugar de reiniciar el tratamiento con AVK. Entre las alternativas terapéuticas se encuentra el uso de AOAD en la práctica clínica como se ha demostrado en el manejo de la fibrilación auricular, si bien la limitación actual continúa estando en las restricciones a su prescripción financiadas en España.…”

Section: Discussionunclassified

“…Varios estudios han confirmado la relación que existe entre un RTA más bajo (<65%) y un aumento de las hemorragias vasculares y graves en pacientes tratados con AVK. 10,11 También se ha demostrado que un control subóptimo de la anticoagulación con AVK puede estar asociado a un mayor riesgo de SPT en pacientes con TEV. 12 Recientemente, varios estudios publicados en España han abordado el uso de AVK para el manejo de la anticoagulación.…”

Section: Introductionunclassified

Stroke, systemic embolism, and major bleeding in patients with venous thromboembolism during Vitamin K antagonist treatment. Results from the EVENT HO study

Gavín‐Sebastián¹,

Roldán²,

Llamas-Sillero³

et al. 2022

SANGRE

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Introducción: El tromboembolismo venoso (TEV) causa una alta morbimortalidad. El tratamiento anticoagulante a largo plazo se requiere para prevenir el TEV recurrente. Objetivo: Describir el tratamiento clínico de pacientes tratados con antagonistas de la vitamina K (AVK) que padecen TEV, evolución de ictus/embolia sistémica (ES) y de sangrados mayores, y las acciones que se toman después. Métodos: Estudio observacional retrospectivo en España en pacientes adultos con TEV en tratamiento con AVK durante 2016. Resultados: De 59 pacientes, 21 sufrieron ictus/ES y 38 sangrado mayor. El RTA medio fue 89,1 y 58,7, y la media del último INR fue 2,2 y 2,4 (ictus/ES vs sangrado mayor); 28,6% y 29,0% de los pacientes tenían INR en RTA al ingreso. Hubo un control adecuado del RTA (89,5% vs 41,7%). La interrupción de AVK fue mayor en sangrado mayor y la terapia puente con heparina y el cambio de tratamiento en ictus/ES. Situación más frecuente tras alta hospitalaria: secuelas neurológicas. Conclusiones: Aproximadamente 1 de cada 3 pacientes con TEV que sufrieron ictus/ES o sangrado mayor tenían INR en RTA al ingreso; la mayoría requirieron hospitalización. Los pacientes con sangrado mayor tuvieron peor control del RTA y fueron más propensos a interrumpir el tratamiento anticoagulante.

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“…8,12,14,16 The study characteristics are summarized in Table 1. [8][9][10][11][12][13][14][15][16][17]…”

Section: Study Selection and Study Characteristicsmentioning

confidence: 99%

“…Previous findings have also assessed the predictability of the SAMe-TT 2 R 2 score for poor TTR and adverse clinical outcomes (eg, bleeding or thromboembolism) among patients with AF and venous thromboembolism (VTE) treated with VKAs. [7][8][9][10][11][12][13][14][15][16][17] However, the results were inconsistent, and the association between the SAMe-TT 2 R 2 score and these clinical outcomes remains controversial.…”

Section: Introductionmentioning

confidence: 99%

SAMe-TT₂R₂ to Predict Clinical Outcomes and Time in Therapeutic Range in Patients on Vitamin K Antagonists: A Systematic Review and Meta-Analysis

2023

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Background: The SAMe-TT2R2 score identifies patients on vitamin K antagonists (VKAs) who are more likely to have poor time in therapeutic range (TTR); however, the association between SAMe-TT2R2 and clinical outcomes remains controversial. Objectives: The objective is to assess the association of SAMe-TT2R2 score with clinical outcomes and poor TTR in patients on VKAs. Methods: We searched using the term “SAMe-TT2R2.” Original articles reporting clinical outcomes and SAMe-TT2R2 scores before October 2021 were included. Odds ratios (ORs) of clinical outcomes, diagnostic accuracy parameters of poor TTR (<60%-70%), and mean TTR were extracted. Meta-analysis was performed using random-effects models. Results: Ten studies were included (N = 22 894); 4 showed pooled changes in TTR of −3.61% (95% CI:−4.88% to −2.35%) and −3.98% (95% CI: −6.08% to −1.87%) at SAMe-TT2R2 scores ≥2 and ≥3, respectively, compared with lower scores. The diagnostic accuracy parameters for poor TTR were too heterogeneous to conclude. SAMe-TT2R2 ≥3 significantly correlated with all adverse events (OR = 1.43 [95% CI: 1.29-1.54; P < 0.001]), composite thromboembolism (OR = 1.53 [95% CI: 1.19-1.97; P = 0.001]), and composite bleeding (OR = 1.33 [95% CI: 1.12-1.59; P = 0.001] regardless of the indication, while an SAMe-TT2R2 ≥2 significantly correlated with mortality (OR = 1.32 [95% CI: 1.02-1.70; P = 0.033]). We found no relationship between an SAMe-TT2R2 ≥3 and mortality or between a score ≥2 and clinical outcomes. Conclusions and Relevance: Patients on VKAs with SAMe-TT2R2 ≥3 experienced more adverse events, bleeding, and thromboembolism compared with patients who had an SAMe-TT2R2 <3. However, the score had limited and inconclusive predictability for poor TTR in the study.

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Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients with venous thromboembolism treated with vitamin K antagonists: Findings from the RIETE registry

Cited by 5 publications

References 26 publications

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Stroke, systemic embolism, and major bleeding in patients with venous thromboembolism during Vitamin K antagonist treatment. Results from the EVENT HO study

SAMe-TT₂R₂ to Predict Clinical Outcomes and Time in Therapeutic Range in Patients on Vitamin K Antagonists: A Systematic Review and Meta-Analysis

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Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients with venous thromboembolism treated with vitamin K antagonists: Findings from the RIETE registry

Cited by 5 publications

References 26 publications

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Effect of current smoking on ischemic events in patients with atrial fibrillation taking vitamin K antagonist

Stroke, systemic embolism, and major bleeding in patients with venous thromboembolism during Vitamin K antagonist treatment. Results from the EVENT HO study

SAMe-TT2R2 to Predict Clinical Outcomes and Time in Therapeutic Range in Patients on Vitamin K Antagonists: A Systematic Review and Meta-Analysis

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SAMe-TT₂R₂ to Predict Clinical Outcomes and Time in Therapeutic Range in Patients on Vitamin K Antagonists: A Systematic Review and Meta-Analysis