Kataruka Akash, Kong Xiaowen, Haymart Brian, Kline-Rogers Eva, Almany Steve, Kozlowski Jay, Krol Gregory D, Kaatz Scott, McNamara Michael W, Froehlich James B, Barnes Geoffrey D
1 Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
2 Department of Cardiovascular Medicine, University of Michigan Health System, Ann Arbor, MI, USA.
Vasc Med. 2017 Jun;22(3):197-203. doi: 10.1177/1358863X16682863. Epub 2017 Feb 1.
A high SAMe-TTR score predicted poor warfarin control and adverse events among atrial fibrillation patients. However, the SAMe-TTR score has not been well validated in venous thromboembolism (VTE) patients. A cohort of 1943 warfarin-treated patients with acute VTE was analyzed to correlate the SAMe-TTR score with time in therapeutic range (TTR) and clinical adverse events. A TTR <60% was more frequent among patients with a high (>2) versus low (0-1) SAMe-TTR score (63.4% vs 52.3%, p<0.0001). A high SAMe-TTR score (>2) correlated with increased overall adverse events (7.9 vs 4.5 overall adverse events/100 patient years, p=0.002), driven primarily by increased recurrent VTE rates (4.2 vs 1.5 recurrent VTE/100 patient years, p=0.0003). The SAMe-TTR score had a modest predictive ability for international normalized ratio (INR) quality and adverse clinical events among warfarin-treated VTE patients. The utility of the SAMe-TTR score to guide clinical decision-making remains to be investigated.
高SAm e - TTR评分预示心房颤动患者华法林控制不佳及不良事件。然而，SAm e - TTR评分在静脉血栓栓塞（VTE）患者中尚未得到充分验证。对1943例接受华法林治疗的急性VTE患者队列进行分析，以关联SAm e - TTR评分与治疗范围内时间（TTR）及临床不良事件。SAm e - TTR评分高（>2）的患者中TTR<60%比评分低（0 - 1）的患者更常见（63.4%对52.3%，p<0.0001）。高SAm e - TTR评分（>2）与总体不良事件增加相关（每100患者年7.9次对4.5次总体不良事件，p = 0.002），主要由复发性VTE发生率增加驱动（每100患者年4.2次对1.5次复发性VTE，p = 0.0003）。SAm e - TTR评分对华法林治疗的VTE患者的国际标准化比值（INR）质量和不良临床事件具有适度的预测能力。SAm e - TTR评分指导临床决策的效用仍有待研究。
