scholarly journals Relationship between Mediterranean diet and time in therapeutic range in atrial fibrillation patients taking vitamin K antagonists

EP Europace ◽  
2015 ◽  
Vol 17 (8) ◽  
pp. 1223-1228 ◽  
Author(s):  
Pasquale Pignatelli ◽  
Daniele Pastori ◽  
Tommasa Vicario ◽  
Tommaso Bucci ◽  
Maria Del Ben ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mediterranean Diet ◽  
Vitamin K ◽  
Therapeutic Range ◽  
Vitamin K Antagonists ◽  
Time In Therapeutic Range

scholarly journals Low Performance of a Clinical-Genetic Model in the Estimation of Time in Therapeutic Range in Acenocoumarol-Adherent Patients with Nonvalvular Atrial Fibrillation: The Quality of Anticoagulation Challenge

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Samantha Wasniewski ◽  
Luciano Consuegra-Sánchez ◽  
Pablo Conesa-Zamora ◽  
Luis García de Guadiana-Romualdo ◽  
Pablo Ramos-Ruiz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Body Mass Index ◽  
Body Mass ◽  
Vitamin K ◽  
Therapeutic Range ◽  
Genetic Model ◽  
Vitamin K Antagonists ◽  
Nonvalvular Atrial Fibrillation ◽  
Clinical Genetic ◽  
Time In Therapeutic Range

Background. Anticoagulation with vitamin K antagonists continues to be a challenging task given the difficulty of achieving a correct time in therapeutic range (TTR). The SAMeTT2R2 score has been proposed to identify patients that will be good responders. In this study we aimed to analyse clinical and genetic factors involved in a correct level of anticoagulation in patients with atrial fibrillation and thereby potentially improve the diagnostic performance of SAMeTT2R2 score. Methods. We prospectively included 212 consecutive patients with nonvalvular atrial fibrillation under treatment with acenocoumarol for at least 6 months that were attended in a cardiology outpatient clinic and were categorized as adherent to medication. We carried out a multivariate regression analysis to detect the independent predictive factors of good control. In all patients VKORC1, CYP2C9⁎2, CYP2C9⁎3, and MIR133A2 genotyping was performed. Results. A total of 128 (60.4%) patients presented TTR <70% (average TTR = 63.2). We identified body mass index (OR 0.94, 95%CI 0.89-0.99, p=0.032) and regular vitamin K intake (OR 0.53, 95%CI 0.28-0.99, p= 0.046) as independent predictors of poor anticoagulation control. The discriminatory power of a clinical-genetic model derived from our cohort was significantly better compared to the SAMeTT2R2 score (C-statistic 0.658 versus 0.524, p<0.001). Conclusions. In our study the SAMeTT2R2 score revealed a poor ability in the prediction of TTR. Besides SAMeTT2R2, body mass index and possibly vitamin K intake should be taken into account when deciding the optimal anticoagulation strategy. The information provided by the identified genotypes was marginal.

scholarly journals Vitamin K Antagonist Treatment in Patients With Atrial Fibrillation and Time in Therapeutic Range in Four European Countries

2014 ◽  
Vol 36 (9) ◽  
pp. 1160-1168 ◽  
Author(s):  
François-Emery Cotté ◽  
Hicham Benhaddi ◽  
Isabelle Duprat-Lomon ◽  
Adam Doble ◽  
Nick Marchant ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Therapeutic Range ◽  
Vitamin K Antagonist ◽  
European Countries ◽  
Time In Therapeutic Range

scholarly journals Time to therapeutic range (TtTR), anticoagulation control, and cardiovascular events in vitamin K antagonists–naive patients with atrial fibrillation

2018 ◽  
Vol 200 ◽  
pp. 32-36 ◽  
Author(s):  
Daniele Pastori ◽  
Pasquale Pignatelli ◽  
Francesco Cribari ◽  
Roberto Carnevale ◽  
Mirella Saliola ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Vitamin K ◽  
Therapeutic Range ◽  
Cardiovascular Events ◽  
Vitamin K Antagonists ◽  
Anticoagulation Control

Control of anticoagulation with vitamin K antagonists: overestimation of median time in therapeutic range when assessed by linear interpolation

2016 ◽  
Vol 116 (10) ◽  
pp. 679-686 ◽  
Author(s):  
Felix J. M. van der Meer ◽  
Henk J. Adriaansen ◽  
Frank W. G. Leebeek ◽  
Marieke J. H. A. Kruip ◽  
A. M. H. P. van den Besselaar ◽  
...  
Keyword(s):  
Vitamin K ◽  
Therapeutic Range ◽  
Vitamin K Antagonists ◽  
Linear Interpolation ◽  
Target Range ◽  
Rank Test ◽  
Induction Phase ◽  
Time In Therapeutic Range ◽  
Significant Difference

SummaryPatients receiving vitamin K–antagonists are monitored by regular assessment of the International Normalized Ratio (INR). There are two popular methods for therapeutic control of anticoagulation in patient groups: 1) Time in Therapeutic Range (TTR) assessed by linear interpolation of successive INR measurements; 2) the cross-sectional proportion (CSP) of all patients’ last INRs within range. The purpose of the present study is to compare the two methods using data from 53 Dutch Thrombosis Centres and to develop a semi-quantitative model for TTR based on different types of INR change. Different groups of around 400,000 patients in four consecutive years were evaluated: patients in the induction phase, short-term, long-term, low-target range, high-target range, receiving either acenocoumarol or phenprocoumon, and performing self-management. Each Centre provided TTR and CSP results for each patient group. TTR and CSP were compared using the Wilcoxon signed-rank test. Separately, we analysed the relationship between consecutive INR results regarding in or out of range and their frequency of occurrence in patients of two different cohorts. Good correlation was observed between TTR and CSP (correlation coefficient 0.694–0.950 in low-target range). In long-term acenocoumarol patients (low-target range) the median TTR was significantly higher than CSP (80.0 % and 78.7 %, respectively; p<0.001). In long-term phenprocoumon patients (low-target range) there was no significant difference between median TTR (83.0 %) and median CSP (82.6 %). In conclusion, the correlation between TTR assessed by linear interpolation and CSP was good. TTR assessed by linear interpolation was higher than CSP in patients on acenocoumarol.

scholarly journals Accuracy of an adherence score and time in therapeutic range among patients on chronic use of vitamin K antagonists

2021 ◽  
Vol 10 (8) ◽  
pp. e59510816523
Author(s):  
Sérgio Henrique Simonetti ◽  
Gustavo Bernardes de Figueiredo Oliveira ◽  
Fabiana Cristina Lourenço ◽  
França João Ítalo Dias
Keyword(s):  
Educational Intervention ◽  
Vitamin K ◽  
Therapeutic Range ◽  
High Performance ◽  
Vitamin K Antagonists ◽  
International Normalized Ratio ◽  
Time In Therapeutic Range ◽  
Adherence Score ◽  
Chronic Use

To validate and analyze the accuracy of the Simonetti adherence score among patients on chronic use of vitamin K antagonists and their time in therapeutic range (TTR) of the international normalized ratio as a measure of quality of anticoagulation. A prospective cohort study with a nonrandomized intervention in patients from an anticoagulation center of a public hospital. Baseline data were collected from May to September 2017, and follow-up data were obtained eight months after a nurse-led  educational intervention, which was given to all patients after consent form and after applying the adherence score (N=205). The intervention was undertaken through 30-40 min conversation about relevant factors that had been previously identified in the score derivation study, which comprised drug-drug interactions, inadequate OAC use, comorbidities, effects of food on vitamin K absorption, and invasive procedures. A receiver operating characteristic (ROC) curve was applied to validate the adherence score in terms of prediction of INR out of recommended therapeutic range. At baseline, mean adherence score was 44.69 and standard deviation (SD) was 18.37, and   mean TTR was 41.07 (SD 15.40). Patients were reassessed after   8 months. At follow-up, there were significant improvements in mean adherence score 54.28 (SD 13.13), and in mean TTR 50.99 (SD 26.10). The Simonetti adherence score yielded high performance and accuracy in clinical practice among patients on chronic use of vitamin K antagonists. Our data indicate that nurse led educational intervention yielded favorable impact in terms of adherence score and TTR improvements.

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