title: The SAME-TT2R2 score predicts the quality of anticoagulation control in patients with acute VTE. A real-life inception cohort study.
abstract: 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 follow-up, 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.
authors.affiliation: Gualtiero Palareti, START-Register, c/o Italian Association of Anticoagulated Patients (A. I. P. A.), Via Paolo Fabbri 1/3; 40138 Bologna, Italy, Tel.: +39 3282279868, E-mail: gualtiero.palareti@unibo.it.
authors.forename: Gualtiero
authors.initials: G
authors.lastname: Palareti
authors.forename: Emilia
authors.initials: E
authors.lastname: Antonucci
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Sophie
authors.initials: S
authors.lastname: Testa
authors.forename: Giuliana
authors.initials: G
authors.lastname: Guazzaloca
authors.forename: Anna
authors.initials: A
authors.lastname: Falanga
authors.forename: Vittorio
authors.initials: V
authors.lastname: Pengo
authors.forename: Daniela
authors.initials: D
authors.lastname: Poli
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D015331:Cohort Studies; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D054556:Venous Thromboembolism / Q000097:blood* / Q000188:drug therapy*; D014812:Vitamin K / Q000037:antagonists & inhibitors; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin
keywords: Anticoagulants; SAMe-TT2R2 score; quality control; warfarin