Evaluación del puntaje SAME-TT2R2 en la calidad de la anticoagulación con warfarina

Estudio de cohorte

Abstract

Introduction: atrial fibrillation (AF) is the most common cardiac arrhythmia and is related to embolic events. The efficacy and safety of warfarin in stroke prevention depends on the time in therapeutic range (TTR). Scales have been designed to predict the behavior of TTR at the start of therapy. The objective of this work was to evaluate the predictive and discriminative capacity of the SAMeTT2R2 score in a non-Caucasian population.

Material and methods: retrospective cohort analytical study in patients with non-valvular AF treated with warfarin between 2013 and 2016 in an anticoagulation clinic. The sample was demodemographically and clinically characterized. Poor control of anticoagulation was defined as (TTR / PINNR <65%). The TTR / PINNR <65% and SAMeTT2R2 <= 2 versus> 2 were compared with the Mann-Whitney U test and chi square. ROC curves were constructed to determine scale discrimination. Each of its elements was evaluated through logistic regression.

Results: 646 patients were included (mean age 77 years ± 8.8 years, 51.4% men). The average TTR was 67.7% and the PINNR 63.6%. When comparing the frequency of poor control between SAMeTT2R2 score ?2 versus> 2 with a chi square test, the PINNR was significant (p = 0.004). The discriminative capacity of the scale for the TTR / PINNR was low (AUC: 0.52 and 0.54 respectively). No relationship was found between each of the variables that constitute the SAMeTT2R2 score and the TTR / PINNR.

Conclusions: the SAMeTT2R2 score did not show good predictive and discriminative capacity in the studied population. The quality of anticoagulation is the result of a dynamic process in relation to compliance, health status or intercurrent disease.