Warfarin INR Goal and Durations of Therapy
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University of Michigan Health System
Anticoagulation Program
Guideline for Warfarin INR Goals and Duration of Therapy
|
Indication |
INR Range |
Suggested Duration |
|
Acute myocardial infarction with or at risk for intracardiac thrombus1 Triple antithrombotic therapy after AMI, consider† |
2.0 – 3.0 2.0 – 2.5 |
3 months 3 months |
|
Atrial fibrillation or flutter2 |
2.0 – 3.0 |
Indefinite |
|
Antiphospholipid antibody syndrome3 |
2.0 – 3.0 |
Indefinite |
|
Treatment of deep venous thrombosis (DVT) or pulmonary embolism (PE)4 If provoked by a transient risk factor: If unprovoked: First unprovoked VTE Second unprovoked VTE With high bleed risk With active cancer |
2.0 – 3.0 |
3 months
At least 3 months, then re- evaluate according to patient-specific criteria* Indefinite |
|
Pulmonary Hypertension5 |
1.5 – 2.5 |
Indefinite |
|
Mechanical valve in the aortic position6** Caged ball or Caged Disk |
2.0 - 3.0 2.5 - 3.5 |
Indefinite Indefinite |
|
Mechanical valve in the mitral position7** |
2.5 – 3.5 |
Indefinite |
|
Mechanical valves in both aortic and mitral position6** |
2.5 – 3.5 |
Indefinite |
|
Bioprosthetic valve in mitral position6 |
2.0 – 3.0 |
3 months then continue aspirin 50-100 mg/d |
|
Prophylaxis of VTE post-total hip or knee replacement surgery |
2.0 – 3.0 |
1 month |
†Consider reduced INR goal if triple therapy (warfarin plus dual antiplatelet therapy) deemed necessary
*Criteria for evaluation of treatment duration include individual patient’s anatomical clot location, bleeding risk, and patient preference.
**Add low-dose aspirin (50-100mg/d)