Validation of the SAMe-TT2R2 score in a nationwide population of nonvalvular atrial fibrillation patients on vitamin K antagonists

Martín Ruiz-Ortiz; Vicente Bertomeu; Ángel Cequier; Francisco Marín; Manuel Anguita

doi:10.1160/TH15-02-0169

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(04): 695-701
DOI: 10.1160/TH15-02-0169

Coagulation and Fibrinolysis

Schattauer GmbH

Validation of the SAMe-TT₂R₂ score in a nationwide population of nonvalvular atrial fibrillation patients on vitamin K antagonists

Martín Ruiz-Ortiz

¹Cardiology Department, Reina Sofía University Hospital, Córdoba, Spain

,

Vicente Bertomeu

²Cardiology Department, San Juan University Hospital, Alicante, Spain

,

Ángel Cequier

³Cardiology Department, Bellvitge University Hospital, Barcelona, Spain

,

Francisco Marín

⁴Cardiology Department, Virgen de la Arrixaca University Hospital, Murcia, Spain

,

Manuel Anguita

¹Cardiology Department, Reina Sofía University Hospital, Córdoba, Spain

› Author Affiliations

Abstract

Summary

The SAMe-TT₂R₂ score has been proposed to identify patients with non valvular atrial fibrillation (AF) who maintain a high average time in therapeutic range (TTR) on vitamin K antagonists treatment (VKA). This score has been validated in several studies, either monocentric or including very selected populations in a specialised setting. Our objective was to validate this score in a nationwide cohort of AF patients. From November 2013 to March 2014 we included in this study the first 10 patients with AF on VKA consecutively seen in 120 outpatient cardiology clinics in Spain. The SAMe-TT₂R₂ score was calculated for each patient and TTR in the preceding six months was estimated by Rosendaal method. A total of 1,056 patients were recruited (mean age 73.6 ± 9.8 years, 42 % female). Mean value of TTR was 63.8 ± 25.9 % (median 66.8 %, interquartile range 45.6 %-85.4 %). We found a progressive decline in mean TTR from a score of 0 (67.5 % ± 24.6 %) to4 (52.7 ± 28.7 %, p< 0.01). The score was able to discriminate which patients had a good anticoagulation control (TTR65 %) with a C-statistic of 0.57 (95 %CI 0.53–0.60, p< 0.0005). A SAMe-TT₂R₂ score of 0–1 was associated with a good anticoagulation control with a sensitivity, specificity, positive and negative predictive values of 64 %, 48 %, 58 % and 54 %, respectively; and the odds ratio of having a TTR< 65 % if the score was2 was 1.64 (95 % confidence interval 1.33–1.95, p< 0.001). In conclusion, in this nationwide population with AF on VKA, the SAMe-TT₂R₂ score had a significant, although moderate, ability to identify patients with a good anticoagulation control.

Keywords

SAMe-TT₂R₂ score - atrial fibrillation - anticoagulation - time in therapeutic range - validation

Full Text

References

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