Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom.
Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Heart Rhythm. 2018 Apr;15(4):615-623. doi: 10.1016/j.hrthm.2017.11.026. Epub 2017 Nov 24.
Identifying patients who are likely to achieve and maintain a therapeutic international normalized ratio when prescribed a vitamin K antagonist for stroke prevention in atrial fibrillation (AF) and venous thromboembolism (VTE) is challenging. The SAMe-TTR score was developed on the basis of common clinical factors that can highlight patients who may be unable to achieve and maintain good anticoagulation control and for whom a "trial of warfarin" would be inadvisable. This review summarizes the main published prospective and retrospective studies that have validated the SAMe-TTR score in patients with AF and VTE treated with a vitamin K antagonist and how the SAMe-TTR score could aid clinical decision making; 19 studies were included. Taken together, validation studies suggest that the SAMe-TTR score is able to predict good or poor anticoagulation control in patients with AF and VTE, although data on patients with VTE are limited (3 studies). The available evidence suggests that the SAMe-TTR score may be a useful tool to aid clinical decision making for oral anticoagulants in patients with AF and VTE.
确定在因心房颤动（AF）和静脉血栓栓塞（VTE）而服用维生素 K 拮抗剂预防卒中的患者中，哪些患者可能达到并维持治疗性国际标准化比值是具有挑战性的。SAMe-TTR 评分是基于可能突出那些可能无法达到和维持良好抗凝控制的患者的常见临床因素而开发的，对于这些患者，“华法林试验”是不合适的。本综述总结了主要的已发表的前瞻性和回顾性研究，这些研究在接受维生素 K 拮抗剂治疗的 AF 和 VTE 患者中验证了 SAMe-TTR 评分，以及 SAMe-TTR 评分如何辅助临床决策；共纳入 19 项研究。总的来说，验证研究表明，SAMe-TTR 评分能够预测 AF 和 VTE 患者的抗凝控制情况良好或不佳，尽管关于 VTE 患者的数据有限（3 项研究）。现有证据表明，SAMe-TTR 评分可能是一种有用的工具，可辅助 AF 和 VTE 患者使用口服抗凝剂的临床决策。
