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Anticoagulation Management 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 Eighth American College of Chest Physicians Consensus Conference (2008).
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 Suggested Duration
Prophylaxis of venous thrombosis (total hip replacement, total knee arthroplasty and hip fracture surgery) 2.0-3.0 2.5 1 month
Treatment of venous thrombosis

Treatment of PE
2.0-3.0 2.5 3-6 months

AMI (to prevent systemic embolism)

(On aspirin and Clopidogrel)

2.0-3.0

2.0 - 2.5

2.5

 

3-6 months

3-6 months

Atrial fibrillation and/or flutter 2.0-3.0 2.5 indefinite
Certain patients with thrombosis and antiphospholipid antibody syndrome 3.0 - 4.0 3.5 indefinite
Tissue and mechanical heart valves      

 

Revised 6/15/2009