Table 4. Target INR for various conditions

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
ALTER NATIVE
ADD
LEFT VENTRICULAR DISEASE .

Dilated cardiomyopathy (EF<30%).
2.0-3.0
Long-term
No Rx
.

Dilated cardiomyopathy (EF<30%), & emboli.
2.0-3.0
Long-term
.
a

S/P anterior MI, LV thrombus.
2.0-3.0
3 months
.
a
.
SYSTEMIC EMBOLI.
.

Systemic emboli.
2.0-3.0
Long-term
.
a
.
VALVULAR DISEASES.
.

Rheumatic MV disease, NSR, LA > 5.5 cm,
2.0-3.0
Long-term
.
a
Mitral valvuloplasty 2.0-3.0 3 wk before,
4 wk after
TEE prior to procedure
.

MV prolapse, unexplained TIA or ischemic stroke

.
Long-term

.ASA 50-100
.

Mitral annular calcification (MAC).
(No anticoag. Rx by itself)
.
.

MAC, systemic emboli (calcific) without atrial fibrillation

.
Long-term

.ASA 50-100

AV disease

(No anticoag. Rx by itself) . . .
.
PFO OR ATRIAL SEPTAL ANEURYSM.
.

PFO with ischemic stroke

.
Long-term

ASA 50-100

 .

PFO with cryptogenic ischemic stroke particular with DVT

2.0-3.0
Long-term
IVC filter, Close PFO
a
PFO.
ENDOCARDITIS.
.

Native valve or bioprotheses, with systemic emboli during endocarditis.
Uncertain Rx
.
.
.
Mechanical prostheses, during endocarditis.
Continue anticoagulation, should temporary replace warfarin with heparin
 . .

Nonbacterial thrombotic endocarditis (NBTE) with systemic or pulmonary emboli.
Heparin
.
.
.

Aseptic vegetation (in patients with disseminated cancer or debilitating disease)
Heparin
 . . .
.
ASCENDING AORTA, AORTIC ARCH.
.

Ascending aorta, aortic arch. Mobile plaque >4 mm (TEE).
2.0-3.0
Long-term
.
a

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)