Prediction of unstable anticoagulation with acenocoumarol versus warfarin in atrial fibrillation

Bryk, Agata Hanna; Plens, Krzysztof; Undas, Anetta

doi:10.5603/cj.a2017.0038

Cited by 6 publications

(4 citation statements)

References 27 publications

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“…In Iran, warfarin is mainly used for anticoagulant therapy in patients with a heart valve prosthesis. However, a previous study showed that the SAMe-TT2R2 (sex female, age, medical history, treatment, tobacco use, race) score appears less effective in predicting unstable anticoagulation with acenocoumarol compared with warfarin [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio and bleeding complications

Zandi¹,

Imani²,

Safarpour³

2021

kitp

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Aim The aim of the study was to determine the effect of self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio (INR) and bleeding complications. Material and methods Design: A quasi-experimental study. Participants were recruited via convenience sampling and were randomly divided into two groups: control ( n = 80) and intervention ( n = 80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of informational support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using the independent t -test and χ 2 in SPSS16 software at a significance level of 0.05. Results During 6 months of follow-up, except for the third month, the frequency of INR levels in the therapeutic target range (2.5–3.5) in the intervention group was significantly higher than that in the control group ( p < 0.05). Also in the intervention group, the incidence of bleeding complications was lower than that in the control group, but this difference was not statistically significant ( p > 0.05). Conclusions Proper self-care training and informational support in patients with mechanical heart valve replacement have positive results. By maintaining self-care, the level of a therapeutic target range of INR can be maintained and the incidence of bleeding complications can be reduced.

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Section: Introductionmentioning

confidence: 99%

Self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio and bleeding complications

Zandi¹,

Imani²,

Safarpour³

2021

kitp

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“…An interesting finding was recently reported by Bryk et al [ 31 ] and is substantial in countries like Spain where the most widely used VKA is acenocoumarol. By comparing the predictive ability of SAMeTT 2 R 2 score in patients with AF treated with warfarin versus acenocoumarol, they detect that it is less effective in predicting unstable anticoagulation with the latter and improves significantly by adding statin use and the presence of COPD (0.66; 95% CI 0.58-0.73 versus 0.56; 0.48-0.64, p = 0.042).…”

Section: Discussionmentioning

confidence: 54%

Low Performance of a Clinical-Genetic Model in the Estimation of Time in Therapeutic Range in Acenocoumarol-Adherent Patients with Nonvalvular Atrial Fibrillation: The Quality of Anticoagulation Challenge

Wasniewski

Consuegra-Sánchez

Conesa‐Zamora

et al. 2018

BioMed Research International

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Background Anticoagulation with vitamin K antagonists continues to be a challenging task given the difficulty of achieving a correct time in therapeutic range (TTR). The SAMeTT2R2 score has been proposed to identify patients that will be good responders. In this study we aimed to analyse clinical and genetic factors involved in a correct level of anticoagulation in patients with atrial fibrillation and thereby potentially improve the diagnostic performance of SAMeTT2R2 score. Methods We prospectively included 212 consecutive patients with nonvalvular atrial fibrillation under treatment with acenocoumarol for at least 6 months that were attended in a cardiology outpatient clinic and were categorized as adherent to medication. We carried out a multivariate regression analysis to detect the independent predictive factors of good control. In all patients VKORC1, CYP2C9⁎2, CYP2C9⁎3, and MIR133A2 genotyping was performed. Results A total of 128 (60.4%) patients presented TTR <70% (average TTR = 63.2). We identified body mass index (OR 0.94, 95%CI 0.89-0.99, p=0.032) and regular vitamin K intake (OR 0.53, 95%CI 0.28-0.99, p= 0.046) as independent predictors of poor anticoagulation control. The discriminatory power of a clinical-genetic model derived from our cohort was significantly better compared to the SAMeTT2R2 score (C-statistic 0.658 versus 0.524, p<0.001). Conclusions In our study the SAMeTT2R2 score revealed a poor ability in the prediction of TTR. Besides SAMeTT2R2, body mass index and possibly vitamin K intake should be taken into account when deciding the optimal anticoagulation strategy. The information provided by the identified genotypes was marginal.

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“…Decision-making could be guided by a strategy that assesses the probability of stabilized anticoagulation during VKAs treatment. Recently, apostolakis et al have proposed and validated the SAMe-TT 2 R 2 score (Sex (female), age <60 years, medical history* and treatment* -interacting drugs-"all 1 point"; as well as current tobacco use "2 points" and race (non-Caucasian; 2 points) [4]. *Medical history includes at least 2 of the following: hypertension, diabetes, coronary artery disease/myocardial infarction, peripheral arterial disease, congestive heart failure, previous stroke, pulmonary disease, hepatic or renal disease, and treatment interacting drugs, eg, amiodarone [4].…”

Section: Introductionmentioning

confidence: 99%

“…The new 8-point score (SAMe-TT 2 R 2 score) that was introduced in 2013 states that patients with a score of 0 to 1 (low risk group) should receive VKAs treatment, while patients with a score of 2 or higher (high risk group) are recommended to use non-VKAs oral anticoagulants as an alternative treatment [4]. This score was derived from the AF Follow-up Investigation of Rhythm Management (AFFIRM) trial population and externally validated in a small "real world" cohort of anticoagulated non-valvular AF patients [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Modified SAMe-TT2R2 Score to Predict Good Anticoagulation Control with Warfarin Among non-valvular Atrial Fibrillation Patients

Bahmaid¹,

Almarzouq²

2021

J Cardiol Res Rev Rep

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Background: The SAMe-TT2 R2 Score was developed to identify vitamin K antagonists control outliers before non-valvular atrial fibrillation (AF) patients start treatment. SAMe-TT2 R2 Score was derived and validated using a primarily white Caucasian population to predict TTR. Given that non-Caucasian race already confers 2 points in this score, the SAMe-TT2 R2 score requires validation and/or re-calibration despite race of population. Method: We conducted a cohort retrospective study that included all non-valvular atrial fibrillation patients who were on warfarin therapy from January to December 2019. Then we calculated the modified SAMe-TT2 R2 and SAMe-TT2 R2 for all study populations and we correlated the result with patients' TTR. The TTR was calculated through the Rosendaal's method. Results: We had 662 patient using warfarin therapy, among those 662, 60.9% were under cardiology and using it for cardiac indication, and only 18.1% diagnosed to have non-valvular AF. Modified SAMe-TT2 R2 score has good relation to original SAMe-TT2 R2 score as showed 75.71% (95% CI. 63.99 to 85.17%), 100% (95% CI. 92.89 to 100%) and 15% (95% CI. 3.21 to 77.95%); accuracy, sensitivity and specificity in relation to SAMe-TT2 R2 respectively. In addition to that in this small cohort we found that there is universal relationship between SAMe-TT2 R2 score, Modified SAMe-TT2 R2 score and TTR; TTR >=65% associate with low score (<2) of both SAMe-TT2 R2 , Modified SAMe-TT2 R2 score. Conclusion: The use of Modified SAMe-TT2 R2 score allows clinicians to make an informed decision on whether to start vitamin K antagonist or other non-vitamin K antagonist oral anticoagulant despite the race of the patients.

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Prediction of unstable anticoagulation with acenocoumarol versus warfarin in atrial fibrillation

Cited by 6 publications

References 27 publications

Self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio and bleeding complications

Self-care training and informational support of patients with a mechanical heart valve on the international normalized ratio and bleeding complications

Low Performance of a Clinical-Genetic Model in the Estimation of Time in Therapeutic Range in Acenocoumarol-Adherent Patients with Nonvalvular Atrial Fibrillation: The Quality of Anticoagulation Challenge

Evaluation of the Modified SAMe-TT2R2 Score to Predict Good Anticoagulation Control with Warfarin Among non-valvular Atrial Fibrillation Patients

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