Anticoagulation Service For Health Professionals

Intensity of Warfarin Anticoagulation for Different Thrombotic Disorders

Notes:
1. These indications and recommended intensities of treatment are derived from the Seventh American College of Chest Physicians Consensus Conference (2004).
2. For most indications a therapeutic range of 2.0 to 3.0 is recommended. A higher INR range of 2.5 to 3.5 is recommended for parents with mechanical prosthetic valves and post myocardial infarction and for some patients with antiphospholipid syndrome and a history of thrombosis.

Intensity of Warfarin Anticoagulation
American College of Chest Physicians Guidelines*

Indication INR Range Target

Prophylaxis of venous thrombosis (total hip replacement, total knee arthroplasty and hip fracture surgery)
Treatment of venous thrombosis
Treatment of PE
Prevention of systemic embolism
Tissue heart valves
AMI (to prevent systemic embolism)
Valvular heart disease
Atrial Fibrillation

2.0-3.0 2.5

Mechanical prosthetic valves (high risk)
Certain patients with thrombosis and antiphospholipid syndrome
AMI (to prevent recurrent AMI)

2.5-3.5

3.0

Bileaflet mechanical valve in aortic position, NSR 2.0-3.0 2.5