What Is the Usual Target Range of the International Normalized Ratio of the Prothrombin Time in Patients with Atrial Fibrillation?

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What Is the Usual Target Range of the International Normalized Ratio of the Prothrombin Time in Patients with Atrial Fibrillation?

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The recommended range is 2.0-3.0. This target range reduces the rate of stroke with a minimum and acceptable risk of bleeding. For patients with special risk factors, such as mechanical prosthetic heart valves and history of recurrent thromboembolism despite warfarin prophylaxis, a higher intensity of anticoagulant prophylaxis is needed (range of INR 3.0 to 4.5). However, it should be pointed out that the risk of bleeding in patients with warfarin increases exponentially with an increase in anticoagulant effect, rising from an annual risk of 0.2% with an INR of Recommended Reading Albers GW: Atrial fibrillation and stroke. Arch Intern Med 1994; 154:14431448. Lip GYH, Lowe GDO: Antithrombotic treatment for atrial fibrillation. BMJ 1996;312:4549.

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