Table 3. Target INR for Venous Thromboembolism. Deep Vein Thrombosis (DVT) and Pulmonary Emboli (PE)

Adapt From ANTITHROMBOTIC AND THROMBOLYTIC THERAPY, 8TH ED: ACCP GUIDELINES : Executive Summary

Jack Hirsh, Gordon Guyatt, Gregory W. Albers, Robert Harrington and Holger J. Schünemann
Chest June 2008 133 : 71S - 109S ; doi:10.1378/chest.08-0693

.	INR DURATION	ALTERNATIVE
Secondary (reversable cause) deep vein thrombosis (DVT) or pulmonary emboli (PE). First episode	2.0-3.0 3 months	.
Idiopathic DVT or PE. First episode	2.0-3.0 6-12 months	May consider long-term, particularly proximal DVT
Idiopathic DVT or PE. Second episode	2.0-3.0 Long-term	3 months for distal DVT
DVT or PE with cancer	2.0-3.0 Until cancer is resolved	LMWH for the first 3-6 months
DVT or PE with antiphospholipid antibodies. First episode	2.0-3.0 12 months	May consider long- term
DVT or PE with deficiency of coagulation factors *. First episode	2.0-3.0 6-12 months	May consider long-term
Recurrent episodes of DVT or PE	2.0-3.0 Long-term	.

For Pacific-Asian (exclude caucasian in this region), The INR range of 2.0-3.0 and 2.5-3.5 may be substituted with INR range of 1.6-2.6 and 2.0-3.0 respectively (Requires more validation)

• Start heparin with warfarin. Prefer Low molecular weight heparin (LMWH) over Unfractionated heparin (UFH).
• Discontinue heparin 2 days after target INR has reached.
• May use thrombolytic treatment in massive or life threatening pulmonary emboli.
• Duration of 12 months or more in cases of recurrent VTE, cancer, antithrombin deficiency, antithrombin antibody syndrome, protein C or protein S deficiency,
• * = multiple thrombophilic conditions, antithrombin deficiency, antithrombin antibody syndrome, protein C or protein S deficiency, hemocystienemia, homozygous factor V Leidin.
• Insert inferior vena caval filter in cases of high risk of VTE and cannot use anticoagulation, recurrent VTE or pulmonary emboli with pulmonary hypertension despite adequate anticoagulation.