IJCS | Volume 31, Nº5, September / October 2018

486 Figure 1 - Study diagram. OAC: oral anticoagulation; AF: atrial fibrillation; VTE: venous thromboembolism; DVT: deep vein thrombosis; NOAC: novel oral anticoagulants. 5 (3.9%) Concomitant OAC indication Pivatto Júnior et al. SAMe-TT 2 R 2 score forVTE patients? Int J Cardiovasc Sci. 2018;31(5)483-491 Original Article Low- and high-risk SAMe-TT 2 R 2 groups had similar mean TTR: 51.9 ± 20.1% vs. 49.6 ± 23.1% (p = 0.593) (Figure 2). The results for the two groups remained similar even after excluding patients on anticoagulation for up to 3 months (n = 6, 5.4%): 51.8 ± 19.7% vs. 49.1 ± 22.6% (p = 0.593). The two groups did not differ significantly in the percentage of patients achieving a TTR ≥ 65% (35.6 vs. 25.8%; p = 0.370). The correlation between TTR and SAMe- TT 2 R 2 score was poor (r = - 0.093; p = 0.330). The c-statistic was 0.595 (95%CI: 0.482 - 0.708; p = 0.113) for TTR ≥ 65%. Adverse events during anticoagulation are shown in Table 2. There were no cases of stroke, transient ischemic attack or myocardial infarction during follow-up. None of the deaths during follow-up was related to bleeding. Of six deaths, five were cancer-related and one was related to respiratory tract infection. Adverse event-free survival was similar in both low- and high-risk SAMe- TT 2 R 2 groups (p = 0.136) (Figure 3). Discussion In the present study, low- and high-risk SAMe-TT 2 R 2 groups had similar mean TTR, and the prevalence of patients with a high TTR did not differ significantly between groups. In addition, the SAMe-TT 2 R 2 score had poor accuracy in predicting both good TTR and adverse events during anticoagulation. Therefore, based on these findings, the score does not seem to be a useful tool in oral anticoagulation decision-making for patients with VTE. The SAMe-TT 2 R 2 score has been developed and validated for use in patients with AF, 6 with good results in predicting which patients will have poor anticoagulation control with VKA therapy. Several studies have confirmed the predictive ability of the score in patients with AF 7,18-29 and described its association with adverse events (death, bleeding, and stroke). 7,18-21,25,26 Its use in patients with VTE, however, has only been recently assessed in three studies, with conflicting results. In a multicenter European study including 1,308 patients, 9 high-risk patients (score ≥ 2) had a lower TTR than low-risk patients, both during the first 3 months of treatment (53 vs. 61%; p = 0.0001) and during the entire treatment period (56 vs. 61%; p = 0.017). Despite the promising results, c-statistic was only 0.52 (p = 0.35) for TTR < 65% and there was no association with bleeding or thrombotic events. Conversely, in a