SAMe-TT2R2 score for prediction of suboptimal time in therapeutic range in a Thai population with atrial fibrillation

Krittayaphong, Rungroj; Winijkul, Arjbordin; Pirapatdit, Atthasit; Chiewvit, Pollakrit; Komoltri, Chulalak; Boonyapisit, Warangkna; Arunsiriwattana, Suchart; Bunyapipat, Tanita; Apiyasawat, Sirin; Rattanasumawong, Kasem; Yindeengam, Ahthit; Investigators, Cool-Af

doi:10.11622/smedj.2019143

Cited by 10 publications

(3 citation statements)

References 26 publications

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“…[19] Rungroj et al studied 1669 patients including 22 centers across Thailand and found that the SAMe-TT 2 R 2 score was the only independent predictor of sub-optimal TTR among NVAF patients treated with warfarin. [20] However, there are some studies that shows this score cannot do so. A systematic review and simulation meta analysis conducted by Miert et al pointed out that although the SAMe-TT 2 R 2 score could predict low TTR, it's effect was limited and not very useful clinically [21] .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients after Mitral Valve Replacement

Gao

et al. 2021

Preprint

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Background:This study aimed to evaluate the role of SAMe-TT2R2 score in the prediction of anticoagulation control after mechanical mitral valve replacement.Methods and Results:We retrospectively reviewed clinical data of 161 patients who received mechanical mitral valve replacement at Beijing Anzhen Hospital from January 2013 to December 2013. Collected data included general information of patients, medication and smoking, postoperative embolism due to anticoagulant, bleeding complications and death information. In the SAMe-TT2R2 score results, the lowest score was 2 points (6.3%), the highest score was 7 points (0.7%). The number of people with 4 points was the largest ,60 people (41.4%).When the cut-off value of SAMe-TT2R2 score was set to ≥4, the sensitivity and specificity of predicting TTR≥65% were 69.8% and 93.1%, respectively. The Youden index was 0.629. If the cut-off value of SAMe-TT2R2 score was set to ≤4, the sensitivity and specificity of predicting TTR≥65% were 93.0% and 44.1%, respectively, and the Youden index was 0.371.ROC curve evaluates the predictive power of the SAMe-TT2R2 score for TTR≥65%. The figure showed that when the cut-off point≥4, the best combination of sensitivity and specificity was shown (69.8% and 93.1%, respectively).The area under the curve AUC was 0.854.Conclusions:After mechanical mitral valve replacement, the SAME-TT2R2 model can effectively predict the level of TTR during the course of using oral warfarin anticoagulation, and the SAMe-TT2R2 score ≥4 can be used to predict TTR<65%.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients after Mitral Valve Replacement

Gao

et al. 2021

Preprint

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“…Sus principales desventajas incluyen las marcadas interacciones farmacológicas y dietéticas, y el requisito de una monitorización de la coagulación seriada mediante el estudio del INR. Es así que se ha descrito en distintas series de casos un porcentaje cercano a 40-60% de pacientes que presentan una ACO subóptima con warfarina, definida como un tiempo en rango terapéutico < 65% (53,54) . El score SAMe-TT2R2 incluye como variables el sexo, la edad, los antecedentes patológicos, los fármacos concomitantes, el tabaquismo y la raza, y ha demostrado ser un buen predictor de una ACO subóptima con el uso de warfarina (52,54) , con valores > 3 puntos es preferible utilizar ACOD (19) .…”

Section: A) ¿Qué Riesgo Hemorrágico Y Trombótico Presenta El Paciente?unclassified

Antitrombóticos en las prótesis valvulares biológicas: ¿cuál es el mejor camino a seguir?

2021

RUC

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“…Poor time in therapeutic range (TTR) is another problem that is common among AF patients taking warfarin. Use of the SAMe-TT 2 R 2 score was recently proposed to predict poor TTR [ 15 – 22 ]. Recent European guidelines recommend considering VKA or NOACs if a patient’s SAMe-TT 2 R 2 score is within the range of 0–2 [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety outcomes of patients with atrial fibrillation compared between warfarin and non-vitamin K antagonist oral anticoagulants based on SAMe-TT2R2 score

Methavigul

Yindeengam

Krittayaphong

2023

BMC Cardiovasc Disord

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Objectives This study aimed to investigate the efficacy and safety outcomes of patients with atrial fibrillation (AF) compared between those taking warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) based on SAMe-TT2R2 score. Methods AF patients using warfarin or NOACs were enrolled from Thailand’s COOL-AF registry. A low SAMe-TT2R2 score was defined as a score of 0–2. The efficacy outcomes were all-cause death, ischemic stroke (IS), transient ischemic attack (TIA), and/or systemic embolization (SE). The safety outcome was major bleeding (MB). The secondary outcome was a combination of cardiovascular (CV) death, IS/TIA/SE, or MB. Cox proportional hazards model was used to compare the event rate between the AF patients taking warfarin and NOACs according to SAMe-TT2R2 score. Results A total of 2568 AF patients taking oral anticoagulants were enrolled. Warfarin and NOACs were used in 2340 (91.1%) and 228 (8.9%) patients, respectively. Among overall patients, 305 patients taking warfarin (13.0%) and 21 patients taking NOACs (9.2%) had the efficacy outcome, while 155 patients taking warfarin (6.6%) and 11 patients taking NOACs (4.8%) had the safety outcome. After adjustment for confounders, overall patients taking warfarin had significantly more secondary outcome than those taking NOACs (11.4% vs. 7.5%, respectively; adjusted hazard ratio: 1.74, 95% confidence interval: 1.01–2.99; p = 0.045) regardless of SAMe-TT2R2 score. Conclusions AF patients taking warfarin had a significantly higher CV death or IS/TIA/SE or MB compared to those taking NOACs regardless of SAMe-TT2R2 score. The results of this study do not support the use of SAMe-TT2R2 score to guide OAC selection.

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SAMe-TT2R2 score for prediction of suboptimal time in therapeutic range in a Thai population with atrial fibrillation

Cited by 10 publications

References 26 publications

Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients after Mitral Valve Replacement

Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients after Mitral Valve Replacement

Antitrombóticos en las prótesis valvulares biológicas: ¿cuál es el mejor camino a seguir?

Efficacy and safety outcomes of patients with atrial fibrillation compared between warfarin and non-vitamin K antagonist oral anticoagulants based on SAMe-TT2R2 score

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