Predicting Sustained High INR After Excessive Warfarin Anticoagulation

In patients who have supertherapeutic INRs while taking warfarin, therapy typically is discontinued and the INR permitted to fall into the therapeutic range before restarting . . .

In patients who have supertherapeutic INRs while taking warfarin, therapy typically is discontinued and the INR permitted to fall into the therapeutic range before restarting therapy. Sometimes, vitamin K is used as well. It is hard to predict which patients' INRs will normalize quickly after excessive anticoagulation with warfarin.

To identify predictors of sustained high INR after excessive anticoagulation, researchers retrospectively studied data from 633 patients who had received more than 60 days of warfarin therapy in an outpatient anticoagulation clinic. All had warfarin withheld for 2 consecutive days because of an INR >6.0; all had INR measured again on the second day.

Of the 633 patients, 232 (37 percent) still had INRs of ≥4.0 on d…

Reviewing Author

Joel M. Gore, MD