Use of the SAMe-TT ₂R ₂ score to predict anticoagulation control in atrial fibrillation and venous thromboembolism patients receiving vitamin K antagonists: A review

Identifying patients who are likely to achieve and maintain a therapeutic international normalized ratio when prescribed a vitamin K antagonist for stroke prevention in atrial fibrillation (AF) and venous thromboembolism (VTE) is challenging. The SAMe-TT ₂R ₂ score was developed on the basis of common clinical factors that can highlight patients who may be unable to achieve and maintain good anticoagulation control and for whom a “trial of warfarin” would be inadvisable. This review summarizes the main published prospective and retrospective studies that have validated the SAMe-TT ₂R ₂ score in patients with AF and VTE treated with a vitamin K antagonist and how the SAMe-TT ₂R ₂ score could aid clinical decision making; 19 studies were included. Taken together, validation studies suggest that the SAMe-TT ₂R ₂ score is able to predict good or poor anticoagulation control in patients with AF and VTE, although data on patients with VTE are limited (3 studies). The available evidence suggests that the SAMe-TT ₂R ₂ score may be a useful tool to aid clinical decision making for oral anticoagulants in patients with AF and VTE.