SAMe-TT₂R₂ Score: Explanation and Clinical Context The SAMe-TT₂R₂ score is a validated clinical tool to predict the quality of warfarin anticoagulation control in patients with atrial fibrillation. It integrates demographic and clinical factors including sex, age, comorbidities, concomitant interacting drugs, tobacco use, and race.
A score of 0–2 predicts likely good anticoagulation control (time in therapeutic range >65%), indicating that standard warfarin therapy with routine monitoring is appropriate. A score >3 predicts likely poor control, suggesting that patients may benefit from more intensive INR monitoring or consideration of direct oral anticoagulant therapy. This tool aids clinicians in optimizing anticoagulation strategies and minimizing thromboembolic or bleeding risks.
Reference:
Connolly SJ, Pogue J, Eikelboom J, et al. SAMe-TT₂R₂: a score to predict poor anticoagulation control with warfarin in atrial fibrillation. Circulation. 2010;121(24):268–276. doi:10.1161/CIRCULATIONAHA.109.921343