SAMe-TT2R2 predicts quality of anticoagulation in patients with acute venous thromboembolism: The MAQI2 experience

Vasc Med. 2017 Jun;22(3):197-203. doi: 10.1177/1358863X16682863. Epub 2017 Feb 1.

Abstract

A high SAMe-TT2R2 score predicted poor warfarin control and adverse events among atrial fibrillation patients. However, the SAMe-TT2R2 score has not been well validated in venous thromboembolism (VTE) patients. A cohort of 1943 warfarin-treated patients with acute VTE was analyzed to correlate the SAMe-TT2R2 score with time in therapeutic range (TTR) and clinical adverse events. A TTR <60% was more frequent among patients with a high (>2) versus low (0-1) SAMe-TT2R2 score (63.4% vs 52.3%, p<0.0001). A high SAMe-TT2R2 score (>2) correlated with increased overall adverse events (7.9 vs 4.5 overall adverse events/100 patient years, p=0.002), driven primarily by increased recurrent VTE rates (4.2 vs 1.5 recurrent VTE/100 patient years, p=0.0003). The SAMe-TT2R2 score had a modest predictive ability for international normalized ratio (INR) quality and adverse clinical events among warfarin-treated VTE patients. The utility of the SAMe-TT2R2 score to guide clinical decision-making remains to be investigated.

Keywords: anticoagulants; pulmonary embolism; venous thromboembolism (VTE).

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Blood Coagulation / drug effects*
  • Decision Support Techniques*
  • Drug Monitoring / methods
  • Female
  • Humans
  • International Normalized Ratio
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Racial Groups
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Smoking
  • Treatment Outcome
  • Venous Thromboembolism / blood*
  • Venous Thromboembolism / diagnosis
  • Venous Thromboembolism / drug therapy*
  • Venous Thromboembolism / epidemiology
  • Warfarin / adverse effects
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Warfarin