Abstract 16446: Modified Application of SAME-TTR Scoring System in Asian Patients With Atrial Fibrillation for the Selection of Oral Anticoagulants
Introduction: Oral anticoagulants (OACs) are highly recommended to prevent thromboembolism (TE) in patients with atrial fibrillation (AF). SAMe-TT2R2 score has been utilized for the assessment of quality of anticoagulation control with warfarin. However, it is hard to apply SAMe-TT2R2 score in Asian patients with AF, because it has not been proven in those populations and it already regarded Asians as a risk factor (R).
Methods: We analyzed 710 Korean patients with non-valvular AF who took warfarin. Quality of anticoagulation control was assessed as mean time in therapeutic range (TTR) by modified Rosendaal method and defined TTR ≥60% as good control during 2-year follow-up. Each component of SAMe-TT2R2 score was evaluated for the relationship with good control. Further clinical factors were analyzed for the prediction of good anticoagulation control.
Results: SAMe-TT2R2 score failed to have linear relationship with good anticoagulation control. Among each component of SAMe-TT2R2, only female, age, and treatment for rhythm control were associated with good control. Binary logistic regression analysis revealed that heart failure (ejection fraction < 35%; OR 1.78, 95% CI 1.01-3.13), and renal insufficiency (glomerular filtration rate [GFR] < 50 ml/min; OR 1.83, 95% CI 0.95-3.55) were associated with good control. SAMe-TTR score was modified with re-assortment of risk factors as substitution Medical history (Me) and Race (R) for Medical history of heart failure and Renal insufficiency, separately. Modified SA2Me-TR score was re-constructed with relevant risk factors (S, female gender, 1 point; A, age < 60 yr-old, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; R, renal insufficiency, 1 point). Modified SA2Me-TR score demonstrated excellent graded relationship with good anticoagulation control (45.4% vs. 32.0% vs. 22.9% vs. 17.1% vs. 14.3% vs. 0%, linear p<0.001)(model performance c-statics 0.63, 95% CI 0.59-0.67). Modified SA2Me-TR score < 2 identified patients with good anticoagulation control (OR 2.47, 95% CI 1.70-3.59).
Conclusions: Modified application of SAMe-TT2R2 score as SA2Me-TR score was useful to identify patients with good anticoagulation control in Asian patients with AF.
Author Disclosures: K. Lee: None. H. Park: None. N. Yoon: None. J. Cho: None. J. Kim: None. Y. Ahn: None. M. Jeong: None. J. Park: None.
- © 2016 by American Heart Association, Inc.