A New Index to Predict Quality of Anticoagulation Control in Patients On Vitamin K Antagonists: the Dafne Score

Abstract

Aim: To derive a new clinical score to improve the prediction of those at risk of poor International Normalized Ratio control among patients with atrial fibrillation taking vitamin K antagonists. Materials & methods: The score was calculated using PAULA database and validated in the FANTASIIA population. Results: The DAFNE score (cardiovascular Disease, concomitant treatment with Amiodarone, Food/dietary transgression and taking ≥7 pills daily, fEemale sex) score was related to a higher probability of poor International Normalized Ratio control. C-indexes were 0.611 and 0.576 (De Long test, p = 0.007) for the DAFNE and SAMe-TT₂R₂ scores, respectively. Conclusion: The DAFNE score is a new clinical score which may potentially help determine those patients with atrial fibrillation who are at high risk of poor anticoagulation control with vitamin K antagonists.

Lay abstract

Patients with atrial fibrillation are often treated with a group of drugs called vitamin K antagonists. However, taking these drugs can result in poor anticoagulation control in certain patients. This paper aims to find a new way to predict which patients might have a higher risk of poor anticoagulation control. The authors suggest that the DAFNE score, which is shown to be bigger if there is a greater chance of poor anticoagulation control, could be used to help predict patients who might be at risk.

Keywords:

• anticoagulation
• atrial fibrillation
• control
• INR
• SAMe-TT₂R₂
• vitamin K antagonists

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at:www.tandfonline.com/doi/full/10.2217/fca-2020-0122

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.