SAMe-TT2R2 prediction scores, capable of identifying likelihood for poor-quality anticoagulation among patients with atrial fibrillation, were notably higher in patients with obstructive sleep apnea than in those without sleep-disordered breathing.
Filip M. Szymanski, MD, of the department of cardiology, Medical University of Warsaw, Warsaw, Poland and colleagues from other institutions looked at 211 patients with AF scheduled for invasive electrophysiological procedures to determine if obstructive sleep apnea (OSA) relates to low anticipated benefits from vitamin K antagonists based on the SAMe-TT2R2 score.
“The mean SAMe-TT2R2 score, as well as the percentage of patients with SAMe-TT2R2 scores ≥ 2, suggests poor predicted anticoagulation control on [vitamin K antagonists] rises along with the [apnea-hypopnea index],” the researchers wrote.
The investigators performed polygraphy on patients (mean age = 57.1 ± 10.2 years, 62.6% men) for an entire night to diagnose OSA, then calculated their SAMe-TT2R2 scores.
The researchers observed OSA with apnea-hypopnea index ≥ 15/h in 48 (22.7%) patients. Mean SAMe-TT2R2 score was lower in patients without OSA (1.4 ± 0.9) compared with those with mild OSA (1.5 ± 0.9), moderate OSA (1.9 ± 1.1) and severe OSA (2.8 ± 0.6).
A greater proportion of patients with SAMe-TT2R2 ≥ 2 was seen with increasing AHI category — 37% in patients without OSA vs. 41% with mild, 57% with moderate and 100% with severe.
Patients with SAMe-TT2R2 ≥ 2 demonstrated higher incidence of OSA. Additionally, fewer patients demonstrated time in the therapeutic range > 70% among those with moderate or severe OSA compared with no or mild OSA (13.6% vs. 29.6%, P = .03).
“The potential mechanisms responsible for poor anticoagulation control in OSA are associated with lifestyle and high comorbidity rate in this group of patients,” the researchers wrote. - by Allegra Tiver
Disclosure: The researchers report no relevant financial disclosures.