Quality of Anticoagulant Control: SAMe-TT2R2

For physicians there are ways of gauging whether a patient is likely to stay in good INR control. There is an acronym – SAMe-TT₂R₂ (Figure 8)[12] – that provides a number of factors that we can assess. In this acronym, “S” stands for sex (female); A for an age <60 years; “M” for medical history of ≥2 comorbidities; “e” is vacant; “T” stands for atrial fibrillation treatment strategy (ie, rhythm control rather than rate control); “T” for tobacco use; and “R” for race, meaning “non-white”.

On the right are seen the scores that are attributed to these various factors. A good score is only 0-1, because these patients generally will stay in the normal INR range. On the other hand, if the score is ≥2, it is much less likely that the patient’s INR will be well controlled. Camm J. Am J Med 2013; published on-line at http://education.amjmed.com/00000.

References

[12] Apostolakis S, Sullivan RM, Olshansky B, Lip GY. Factors affecting quality of anticoagulation control amongst atrial fibrillation patients on warfarin:The SAMe-TT2R2 (Sex female, Age less than 60, Medical history, Treatment strategy [rhythm control], Tobacco use [doubled], Race [doubled] score. Chest. Published online ahead of print May 9, 2013.