Efficacy and safety outcomes of patients with atrial fibrillation compared between warfarin and non-vitamin K antagonist oral anticoagulants based on SAMe-TT<inf>2</inf>R<inf>2</inf> score
Issued Date
2023-12-01
Resource Type
eISSN
14712261
Scopus ID
2-s2.0-85146809067
Pubmed ID
36690928
Journal Title
BMC Cardiovascular Disorders
Volume
23
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Cardiovascular Disorders Vol.23 No.1 (2023)
Suggested Citation
Methavigul K., Yindeengam A., Krittayaphong R. Efficacy and safety outcomes of patients with atrial fibrillation compared between warfarin and non-vitamin K antagonist oral anticoagulants based on SAMe-TT<inf>2</inf>R<inf>2</inf> score. BMC Cardiovascular Disorders Vol.23 No.1 (2023). doi:10.1186/s12872-023-03053-w Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82028
Title
Efficacy and safety outcomes of patients with atrial fibrillation compared between warfarin and non-vitamin K antagonist oral anticoagulants based on SAMe-TT<inf>2</inf>R<inf>2</inf> score
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Author's Affiliation
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Abstract
Objectives: This study aimed to investigate the efficacy and safety outcomes of patients with atrial fibrillation (AF) compared between those taking warfarin and non-vitamin K antagonist oral anticoagulants (NOACs) based on SAMe-TT2R2 score. Methods: AF patients using warfarin or NOACs were enrolled from Thailand’s COOL-AF registry. A low SAMe-TT2R2 score was defined as a score of 0–2. The efficacy outcomes were all-cause death, ischemic stroke (IS), transient ischemic attack (TIA), and/or systemic embolization (SE). The safety outcome was major bleeding (MB). The secondary outcome was a combination of cardiovascular (CV) death, IS/TIA/SE, or MB. Cox proportional hazards model was used to compare the event rate between the AF patients taking warfarin and NOACs according to SAMe-TT2R2 score. Results: A total of 2568 AF patients taking oral anticoagulants were enrolled. Warfarin and NOACs were used in 2340 (91.1%) and 228 (8.9%) patients, respectively. Among overall patients, 305 patients taking warfarin (13.0%) and 21 patients taking NOACs (9.2%) had the efficacy outcome, while 155 patients taking warfarin (6.6%) and 11 patients taking NOACs (4.8%) had the safety outcome. After adjustment for confounders, overall patients taking warfarin had significantly more secondary outcome than those taking NOACs (11.4% vs. 7.5%, respectively; adjusted hazard ratio: 1.74, 95% confidence interval: 1.01–2.99; p = 0.045) regardless of SAMe-TT2R2 score. Conclusions: AF patients taking warfarin had a significantly higher CV death or IS/TIA/SE or MB compared to those taking NOACs regardless of SAMe-TT2R2 score. The results of this study do not support the use of SAMe-TT2R2 score to guide OAC selection.