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Volume 31, Nº 5, September and October 2018


DOI: http://www.dx.doi.org/10.5935/2359-4802.20180044


SAMe-TT2R2 Score: A Useful Tool in Oral Anticoagulation Decision-Making for Venous Thromboembolism Patients?

Fernando Pivatto Júnior

Rafaela Fenalti Salla

Lísia Cunha Cé

Andréia Biolo

André Luís Ferreira Azeredo da Silva

Bruno Führ

Luís Carlos Amon

Marina Bergamini Blaya

Rafael Selbach Scheffel


Background: The SAMe-TT2R2 score was introduced to identify atrial fibrillation patients with a high risk of not achieving a good time in therapeutic range (TTR) during vitamin K antagonists (VKA) therapy.

Objective: The aim of this study was to evaluate this score in venous thromboembolism (VTE) patients.

Patients and methods: A retrospective cohort study of patients receiving care at the outpatient anticoagulation clinic of a tertiary care teaching hospital. Patients were classified as having low (score 0-1) or high risk (score ≥ 2) of not achieving a good TTR. The area under the ROC curve was calculated to assess the ability of the score to predict a TTR ≥ 65%. Adverse event-free survival curves according to the SAMe-TT2R2 score were calculated by the Kaplan-Meier method and compared by the log-rank test. A P-value < 0.05 was considered statistically significant.

Results: We investigated 111 patients during a median follow-up of 2.3 (0.7-6.4) years. Mean age was 54.1 ± 15.7 years, and 71 (64.0%) were women. Low- and high-risk groups had similar mean TTR (51.9 vs. 49.6%; 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 c-statistic was 0.595 (p = 0.113) for TTR ≥ 65%. Adverse event-free survival during anticoagulation was also similar in both groups (p = 0.136).

Conclusion: The SAMe-TT2R2 score does not seem to be a useful tool in oral anticoagulation decision-making for patients with VTE and should not be used in this setting. (Int J Cardiovasc Sci. 2018;31(5)483-491)

Keywords: Venous thrombosis; Venous thromboembolism; Pulmonary embolism; Anticoagulants; Decision support techniques.