1 Fred Wilson School of Pharmacy, High Point University, NC, USA.
2 College of Pharmacy, University of South Florida, Tampa, FL, USA.
Ann Pharmacother. 2018 Nov;52(11):1085-1090. doi: 10.1177/1060028018779774. Epub 2018 Jun 1.
In patients with stable international normalized ratios, 12-week extended-interval warfarin monitoring can be considered; however, predictors of success with this strategy are unknown. The previously validated SAMe-TTR score (considering sex, age, medical history, treatment, tobacco, and race) predicts anticoagulation control during standard follow-up (every 4 weeks), with lower scores associated with greater time in therapeutic range.
To evaluate the ability of the SAMe-TTR score in predicting success with extended-interval warfarin follow-up in patients with previously stable warfarin doses.
In this post hoc analysis of a single-arm feasibility study, baseline SAMe-TTR scores were calculated for patients with ≥1 extended-interval follow-up visit. The primary analysis assessed achieved weeks of extended-interval follow-up according to baseline SAMe-TTR scores.
A total of 47 patients receiving chronic anticoagulation completed a median of 36 weeks of extended-interval follow-up. The median baseline SAMe-TTR score was 1 (range 0-5). Lower SAMe-TTR scores appeared to be associated with greater duration of extended-interval follow-up achieved, though the differences between scores were not statistically significant. No individual variable of the SAMe-TTR score was associated with achieved weeks of extended-interval follow-up. Analysis of additional patient factors found that longer duration (≥24 weeks) of prior stable treatment was significantly associated with greater weeks of extended-interval follow-up completed ( P = 0.04). Conclusion and Relevance: This pilot study provides limited evidence that the SAMe-TTR score predicts success with extended-interval warfarin follow-up but requires confirmation in a larger study. Further research is also necessary to establish additional predictors of successful extended-interval warfarin follow-up.
在国际标准化比值稳定的患者中，可以考虑进行 12 周的延长间隔华法林监测；然而，这种策略成功的预测因素尚不清楚。先前验证的 SAMe-TTR 评分（考虑性别、年龄、病史、治疗、吸烟和种族）预测标准随访（每 4 周一次）期间的抗凝控制，得分越低与治疗范围内的时间越长相关。
评估 SAMe-TTR 评分在预测先前稳定华法林剂量患者延长间隔华法林随访成功中的能力。
在一项单臂可行性研究的事后分析中，为至少有 1 次延长间隔随访的患者计算了基线 SAMe-TTR 评分。主要分析根据基线 SAMe-TTR 评分评估实现的延长间隔随访周数。
共有 47 名接受慢性抗凝治疗的患者完成了中位数为 36 周的延长间隔随访。中位数基线 SAMe-TTR 评分为 1（范围 0-5）。较低的 SAMe-TTR 评分似乎与延长间隔随访时间的延长有关，但评分之间的差异无统计学意义。SAMe-TTR 评分的单个变量均与实现的延长间隔随访周数无关。对其他患者因素的分析发现，较长时间（≥24 周）的先前稳定治疗与完成的延长间隔随访周数显著增加相关（P=0.04）。结论和相关性：这项初步研究提供了有限的证据表明 SAMe-TTR 评分预测延长间隔华法林随访的成功，但需要在更大的研究中得到证实。还需要进一步的研究来确定成功延长间隔华法林随访的其他预测因素。
