The SAMe-TT
2R
2 score is a
clinical prediction rule A clinical prediction rule or clinical probability assessment specifies how to use medical signs, symptoms, and other findings to estimate the probability of a specific disease or clinical outcome.
Physicians have difficulty in estimated risks of ...
to predict the quality of vitamin K antagonist anticoagulation therapy as measured by time in therapeutic INR range (TTR) (
VKA e.g. warfarin). It has been suggested that it can aid in the medical decision making between VKAs and new oral anticoagulant/non-VKA oral anticoagulant (
NOAC e.g. dabigatran, rivaroxaban, apixaban or edoxaban) in patients with
atrial fibrillation (AF). This score can be used with patients with ≥1 additional stroke risk factors using the
CHA2DS2-VASc score, where oral anticoagulation is recommended or should be considered.
This score reflects the need to offer an improved patient care pathway when using oral anticoagulants. While NOACs avoid the need for drug monitoring (e.g. INR monitoring), they have an unstable bioavailability and are not indicated for patients with chronic
kidney failure
Kidney failure, also known as end-stage kidney disease, is a medical condition in which the kidneys can no longer adequately filter waste products from the blood, functioning at less than 15% of normal levels. Kidney failure is classified as eit ...
or in patients with valvular replacement surgery.
In a newly diagnosed non-anticoagulated AF patient, the physician may avoid a ‘trial of warfarin’ (which may expose patients to increased stroke risk during the initial inception phase, with suboptimal anticoagulation control
[Azoulay L, Dell'Aniello S, Simon TA, Renoux C, Suissa S. Initiation of warfarin in patients with atrial fibrillation: early effects on ischaemic strokes. Eur Heart J. 2014 Jul 21;35(28):1881-7.]) and make an informed decision between patients likely to do well on a VKA (SAMe-TT
2R
2 score 0-2) or where a
VKA is perhaps likely to be associated with poor quality anticoagulation control.
Calculate the SAMe-TT2R2 score
Using the above table add together points assigned for different factors to a maximum score of 8.
Results
See also
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CHA2DS2-VASc score
References
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External links
SAMe-TT2R2 score calculatorRoyal College of Physicians of Edinburgh
The Royal College of Physicians of Edinburgh (RCPE) is a medical royal college in Scotland. It is one of three organisations that sets the specialty training standards for physicians in the United Kingdom. It was established by Royal charter ...
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