A Practical Guide to Haemostasis

Assessing the Risk of Bleeding in Patients with non-valvular Atrial Fibrillation [AF]:
The SAMe-TT2R2 Score


The SAMe-TT2R2 score was originally devised as a system for identifying individuals with Atrial Fibrillation in whom poor anticoagulation control was likely to be a problem.  It was subsequently evaluated in patients with acute VTE to establish whether individuals with a SAMe-TT2R2 score that would predict poor anticoagulant control with a Vitamin K antagonist e.g. Warfarin would  be more effectively treated with a DOAC.

See References for further information on the SAMe-TT2R2 Algorithm.

The SAMe-TT2R2 Algorithm is summarised below:

The SAMe-TT2R2 Algorithm:

Select Criteria:

  Sex [Female]
1 Point
  Age <60 yrs
1 Point
  Medical History1
1 Point
 Treatment [interacting]
1 Point
  Tobacco Use [within 2 yrs]
2 Points
  Race [non-Caucasian]
2 Points
1More than two of the following:
Diabetes, Myocardial Infarction, Peripheral arterial disease, Congestive cardiac failure, Previous CVA, Pulmonary disease, Hepatic or Renal Disease


[Max Score 8 points]

Total No. of Points Interpretation
0-2 Suggests the patient would benefit from a Vitamin K antagonist
>2 Suggests an alternative approach e.g. a DOAC - may be more appropriate.

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