SAMe-TT ₂R₂ score for poor INR control
SAMe-TT₂R₂ score for poor INR control
SAMe-TT₂R₂ score aims at predicting those likely to have poor INR (International Normalized Ratio of Prothrombin Time) control while on vitamin K antagonists [1]. The investigators divided the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial cohort randomly into a derivation cohort and an internal validation cohort.
They used linear regression analysis to find out the clinical parameters associated with time in therapeutic window (TTR) while on warfarin. Binary logistic regression analysis was used to evaluate the predictive performance of a model created using these factors. The prediction model was externally using a prospectively recruited cohort receiving anticoagulation.
SAMe-TT₂R₂ score derived thus had the following parameters:
Sex female
Age < 60 years
Medical history (more than two comorbidities)
Treatment (interacting drugs, eg, amiodarone for rhythm control)
Tobacco use (doubled)
Race (doubled)
Those with scores of zero or 1 did well on warfarin with good TTR. In those with a score of 2 or more, additional interventions are required to achieve adequate anticoagulation. Direct oral anticoagulants (DOACs) may be considered in patients with a score of two or more.
It is not very sure whether this score will do well in those with valvular heart disease as 95% of patients enrolled in the AFFIRM trial did not have valvular disease.
Reference
Apostolakis S, Sullivan RM, Olshansky B, Lip ...
Source: Cardiophile MD - Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology Source Type: blogs
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