The SAME-TT2R2 score predicts the quality of anticoagulation control in patients with acute VTE

Gualtiero Palareti; Emilia Antonucci; Gregory Y. H. Lip; Sophie Testa; Giuliana Guazzaloca; Anna Falanga; Vittorio Pengo; Daniela Poli; for the START-Register Participants

doi:10.1160/TH15-10-0830

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2016; 115(06): 1101-1108
DOI: 10.1160/TH15-10-0830

Coagulation and Fibrinolysis

Schattauer GmbH

The SAME-TT₂R₂ score predicts the quality of anticoagulation control in patients with acute VTE

A real-life inception cohort study

Authors

Gualtiero Palareti

¹Coordinator of the START-Register, Bologna, Italy
Emilia Antonucci

²Monitor of the START-Register, Bologna, Italy
Gregory Y. H. Lip

³University of Birmingham, Institute for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom

⁴Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Sophie Testa

⁵Haemostasis and Thrombosis Centre, Hospital of Cremona, Cremona, Italy
Giuliana Guazzaloca

⁶Angiology and Blood Coagulation, University Hospital of Bologna, Bologna, Italy
Anna Falanga

⁷Division of Immunohematology and Transfusion Medicine; Department of Oncology and Hematology, Ospedali Riuniti di Bergamo, Bergamo, Italy
Vittorio Pengo

⁸Department of Clinical Cardiology, Thrombosis Centre, University of Padua, Padua, Italy
Daniela Poli

⁹Department of Experimental and Clinical Medicine, Thrombosis Centre, University of Florence, Florence, Italy

for the START-Register Participants

Abstract

Summary

The SAMe-TT2R2 score has recently been proposed to predict the quality of vitamin K antagonist (VKA) anticoagulation control in patients with atrial fibrillation. We aimed at investigating whether the score is effective also in patients with venous thromboembolism (VTE). Patients included in the START-Register because started VKA therapy for a recent VTE episode and with > 3 months follow-up were analyzed. The score was calculated using the baseline patient’s characteristics present in the electronic database of the registry, where all INR results were also available and analysed to calculate the time in therapeutic range (TTR). A total of 1308 patients (53.4 % female, median age 68 years) were analysed. During 998 patient-years followup, the median TTR was 63 %. The maximum score in the patients was 4, with 70 % of them having 0–1. INR controls within range (2.0–3.0) were significantly less prevalent in patients with score ≥ 2 vs 0–1 score (58.5 ± 20 % vs 61.5 ± 19 %, respectively, p = 0.046). Patients with score ≥ 2 vs 0–1 had a highly significant lower TTR during the first 3 months of therapy (53 ± 26 % and 61 ± 26 %, respectively; p=0.0001), difference mainly due to more time spent below 2.0 INR (38 ± 28 % vs 31.3 ± 26.7 %, respectively; p=0.0001). In conclusion, the study proved, for the first time, that the SAMe-TT₂R₂ score is useful to predict among VTE patients those who will have good (score 0–1) or less good (score ≥ 2) VKA anticoagulation control. The score can help decision-making in everyday clinical practice, especially when choosing between VKA and non-vitamin K antagonists direct anticoagulants.

Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.

Keywords

Anticoagulants - quality control - warfarin - SAMe-TT2R2 score

Full Text

References

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