A higher international normalized ratio may be better for your patient

Buller, Harry
July 2008
CMAJ: Canadian Medical Association Journal;7/29/2008, Vol. 179 Issue 3, p217
Academic Journal
This article reports on the role of anticoagulant therapy in reducing the risk of thrombosis with the lowest possible risk of bleeding. Since the risk of adverse outcome is almost tripled when patients have an international normalized ratio below 2, slowly increasing the dose of vitamin K antagonists should be reconsidered. It mentions that an international normalized ratio of 2-3 is optimal, but ratios that are slightly higher than this therapeutic range are moderately safe and it is likely that the absolute risk of thrombosis and bleeding at a ratio of 3-4 would be lower than 7 percent annually.


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