Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Thromb Thrombolysis. 2009 Apr;27(3):293-9. doi: 10.1007/s11239-008-0219-9. Epub 2008 Apr 5.

Warfarin: what are the clinical implications of an out-of-range-therapeutic international normalized ratio?

Author information

  • 1Jefferson Center for Vascular Diseases, Jefferson Medical College, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA. Geno.Merli@jefferson.edu

Abstract

Warfarin is a commonly used oral anticoagulant, and has well-established clinical efficacy. However, it has a narrow therapeutic window, and a mode-of-action affected by inter-individual differences and environmental factors. The effectiveness and safety of warfarin are closely related to maintenance of the international normalized ratio (INR) within therapeutic range. A supra-therapeutic INR puts patients at risk of bleeding, whereas a sub-therapeutic INR may not protect against thromboembolic complications. Research suggests a lack of anticoagulation control during warfarin therapy in different settings. Careful monitoring of the INR is essential, especially in geriatric or cancer populations who are at an increased risk of major hemorrhage. Warfarin is an effective treatment but optimization of the risk-benefit ratio is crucial in order to maximize efficacy and safety. Here, we will assess the extent to which INRs are an issue in the management of warfarin therapy, and the effect INRs may have on clinical outcomes.

PMID:
18392557
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Write to the Help Desk