The Sex, Age, Medical History, Treatment, Tobacco Use, Race Risk (SAMe TT₂R₂) Score Predicts Warfarin Control in a Singaporean Population

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• 作者：Nijole Bernaitis ; B Pharm^* ; ^&dagger ; ; Chi Keong Ching ; MBBS ; MRCP(UK) ; FAMS(Cardiology)^&Dagger ; ; Liping Chen ; BSc(Pharmacy)^§ ; ; Jin Shing Hon ; BSc(Pharmacy)^§ ; ; Siew Chong Teo ; B Pharm^§ ; ; Andrew K. Davey ; PhD^* ; ^&dagger ; ; Shailendra Anoopkumar-Dukie ; PhD^* ; ^&dagger ; ; ^{s.dukie@griffith.edu.au}
• 关键词：Warfarin ; predictor model ; anticoagulant ; atrial fibrillation
• 刊名：Journal of Stroke and Cerebrovascular Diseases
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：26
• 期：1
• 页码：64-69
• 全文大小：115 K
• 卷排序：26

文摘

Warfarin reduces stroke risk in atrial fibrillation (AF) patients but requires ongoing monitoring. Time in therapeutic range (TTR) is used as a measure of warfarin control, with a TTR less than 60% associated with adverse patient outcomes. The Sex, Age, Medical history, Treatment, Tobacco use, Race (SAMe-TT2R2) score has been identified as a model able to predict warfarin control, but this has been tested in mainly Caucasian populations. Therefore, the aim of this study was to determine the ability of the SAMe-TT2R2 score to predict warfarin control in a Singaporean population consisting of Chinese, Malay, and Indian race.MethodsRetrospective data were collected from the National Heart Centre Singapore for AF patients receiving warfarin between January and June 2014. The TTR and the SAMe-TT2R2 score were calculated for each patient.ResultsThe 1137 non-valvular AF patients had a mean TTR of 58.0 ± 34.3% and a median SAMe-TT2R2 score of 3. The categorized SAMe-TT2R2 scores (2 versus >2) showed a significant reduction in mean TTR for the entire population (63.2% versus 55.8%, P = .0004) and also when categorized according to race for Chinese (62.7% versus 56.9%, P = .0075) and Malay (68.4% versus 50.6%, P = .0131) populations.ConclusionThe SAMe-TT2R2 tool is effective in predicting warfarin control in a Singaporean population as patients with a score greater than 2 had poor control. The minimum score for non-Caucasian patients is 2; thus, in these patients, the presence of any additional risk factors identified in the SAMe-TT2R2 tool categorizes them as unlikely to achieve adequate warfarin control and possible candidates for alternative anticoagulants.