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Revista Colombiana de Cardiología
Print version ISSN 0120-5633
Abstract
MORA-LLABATA, Vicente et al. Marginal usefulness of the SAMe-TT 2 R 2 score in the prediction of the quality of oral anticoagulation with acenocoumarol in the “real world”. Rev. Colomb. Cardiol. [online]. 2018, vol.25, n.3, pp.185-191. ISSN 0120-5633. https://doi.org/10.1016/j.rccar.2017.10.004.
Introduction:
The SAMe-TT2R2 score has been proposed to predict the quality of anticoagulation with vitamin K antagonists.
Objective:
To validate the discriminatory power of the SAMe-TT2R2 score real-life in a patient cohort with non-valvular atrial fibrillation.
Material and methods:
An observational study was conducted on patients with non-valvular atrial fibrillation treated with vitamin K antagonists for at least six months. Good anticoagulation control was considered a time in the therapeutic range of ≥ 65%, estimated with the Rosendaal method. The relationship between the SAMe-TT2R2 score and the anticoagulation control was evaluated using a binary logistic regression. The discriminatory power was determined using the calculation of the value of the area under the ROC curve.
Results:
The study included total of 241 patients, with a mean age of 78.6±8.6 years, and 53% women. The mean time in the therapeutic range was 59.4±25.4%, low according to the increase in the SAMe-TT2R2 score. In general, the scale did not appear to have the power to discriminate patients with adequate anticoagulation control, with an area under the ROC curve of 0.57 (95% CI: 0.49-0.64, P=.06). It was only useful for extreme scores, with a probability of good control of 65.1% vs. 34.9%, P=.01 for a value of 0, and of 0% vs. 100%, P=.03 for ≥ 4. The disparity ratio of having a time in the therapeutic range of <65% for a score ≥2 was 1.22 (95% CI: 0.73-2.02, P=.44).
Conclusion:
In a cohort of patients with non-valvular atrial fibrillation and with real-life data, the SAMe-TT2R2 scale, did not, on the whole, show discriminatory power for the adequate control of anticoagulation with vitamin K antagonists. It only showed to be useful to correctly classify the cases with extreme scores.
Keywords : Atrial fibrillation; Anticoagulation; Prevention.