SAMe-TTR predicts quality of anticoagulation in patients with acute venous thromboembolism: The MAQI experience.

A high SAMe-TTR score predicted poor warfarin control and adverse events among atrial fibrillation patients. However, the SAMe-TTR 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-TTR 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-TTR score (63.4% vs 52.3%, p<0.0001). A high SAMe-TTR 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-TTR 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-TTR score to guide clinical decision-making remains to be investigated.