A target INR range of 1.5-2.5 with good compliance significantly reduced the risk of bleeding (IRR 0.53) while effectively preventing recurrent venous thromboembolism in patients taking warfarin.
Observational (n=720)
No
Does a target INR of 1.5-2.5 reduce bleeding without increasing recurrent VTE compared to higher INR targets in patients with VTE on warfarin?
A lower target INR of 1.5-2.5 in VTE patients on warfarin provides similar efficacy for preventing recurrence while reducing bleeding risk compared to higher INR targets.
Estimación del efecto: IRR 0.53 (95% CI 0.25-0.98)
Tasa de eventos absoluta: 7.1% vs 14%
valor p: p=0.050
Warfarin is the cornerstone of venous thromboembolism (VTE) treatment. An appropriate international normalized ratio (INR) range of prothrombin time can prevent recurrent VTE and decrease bleeding risk. This study aimed to identify the appropriate INR range for warfarin therapy and evaluate the predictive factors for recurrent VTE and bleeding events. This study included patients diagnosed with VTE and treated with warfarin. We compared three targets of the therapeutic INR range (1.5-2.5, 2.0-3.0, and 2.5-3.5). Among patients with VTE receiving warfarin, no significant differences in VTE recurrence were observed among the three INR targets. Patients with a target INR of 1.5-2.5 had lower bleeding rates than other groups. Smoking was a significant predictive factor for recurrent VTE. Transiently provoked VTE and active cancer were significant risk factors for bleeding, while the target range of INR 1.5-2.5 with good compliance was a protective factor for bleeding. In summary, a target INR of 1.5-2.5 effectively prevented recurrent VTE with minimal bleeding risk in patients taking warfarin. Smoking increases VTE recurrence risk, highlighting the importance of smoking cessation to reduce thrombotic risk. Shorter anticoagulant duration could balance thrombotic and bleeding risks in patients with transiently provoked VTE.
Sae-Lim et al. (Wed,) conducted a observational in Venous thromboembolism (VTE) (n=720). Warfarin with target INR 1.5-2.5 vs. Warfarin with target INR 2.0-3.0 or 2.5-3.5 was evaluated on Bleeding events (target INR 1.5-2.5 with good compliance) (IRR 0.53, 95% CI 0.25-0.98, p=0.050). A target INR range of 1.5-2.5 with good compliance significantly reduced the risk of bleeding (IRR 0.53) while effectively preventing recurrent venous thromboembolism in patients taking warfarin.