Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients after Mitral Valve Replacement

Background: This study aimed to evaluate the role of SAMe-TT 2 R 2 score in the prediction of anticoagulation control after mechanical mitral valve replacement. Methods and Results: We retrospectively reviewed clinical data of 161 patients who received mechanical mitral valve replacement at Beijing Anzhen Hospital from January 2013 to December 2013. Collected data included general information of patients, medication and smoking, postoperative embolism due to anticoagulant, bleeding complications and death information. In the SAMe-TT 2 R 2 score results, the lowest score was 2 points (6.3%), the highest score was 7 points (0.7%). The number of people with 4 points was the largest ,60 people (41.4%).When the cut-off value of SAMe-TT 2 R 2 score was set to ≥4, the sensitivity and specificity of predicting TTR≥65% were 69.8% and 93.1%, respectively. The Youden index was 0.629. If the cut-off value of SAMe-TT 2 R 2 score was set to ≤4, the sensitivity and specificity of predicting TTR≥65% were 93.0% and 44.1%, respectively, and the Youden index was 0.371.ROC curve evaluates the predictive power of the SAMe-TT 2 R 2 score for TTR≥65%. The figure showed that when the cut-off point≥4, the best combination of sensitivity and specificity was shown (69.8% and 93.1%, respectively).The area under the curve AUC was 0.854. Conclusions: : After mechanical mitral valve replacement, the SAME-TT 2 R 2 model can effectively predict the level of TTR during the course of using oral warfarin anticoagulation, and the SAMe-TT 2 R 2 score ≥4 can be used to predict TTR<65%.