What should your INR be with a mechanical heart valve?

A target INR range of 2.5–3.5 is the current recommendation in patients who have undergone mechanical mitral valve replacement [5–7].

What is the INR range for a mechanical aortic valve?

In patients with mechanical heart valves in both the aortic and mitral position, a target INR of 3.0 (range 2.5 to 3.5) is suggested over a target INR of 2.5.

Do prosthetic heart valves require anticoagulation?

All patients with mechanical prosthetic valves require lifelong VKA (eg, warfarin) anticoagulation. Additional indications for anticoagulation, such as atrial fibrillation (AF), may require a higher goal INR than for the mechanical valve alone.

When do you start warfarin after valve replacement?

In order to prevent early thromboembolic complications after heart valve replacement, anticoagulation should be started within 24 h after the procedure using intravenous UFH or subcutaneous LMWH. Sufficient anticoagulation can be achieved with subcutaneous LMWH.

What should INR be on warfarin?

An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for disorders such as atrial fibrillation or a blood clot in the leg or lung. In certain situations, such as having a mechanical heart valve, you might need a slightly higher INR.

How often do you monitor INR?

The CHEST guidelines1 recommend monitoring the INR every 4 weeks in most patients. However, in those patients who have been stable on warfarin therapy for at least 3 months, CHEST suggests that it is reasonable to consider extending the interval between INR checks to 12 weeks.

Why do mechanical valves need warfarin?

Although mechanical heart valves (MHV) are more durable than tissue valves, they are more thrombogenic. Consequently, patients with MHV require long-term anticoagulation with vitamin K antagonists, such as warfarin.

What anticoagulant is used for mechanical heart valve?

Although low-molecular-weight heparin can be used to achieve anticoagulation, the vitamin K antagonist, warfarin, is currently the only oral anticoagulant recommended for patients with aortic and mitral mechanical heart valves.

Does warfarin affect INR?

Changes in warfarin dosage may take several days to affect INR level, therefore it is important that doses are not adjusted more frequently than every four to five days. Changes in the INR level in a usually stable patient may be due to a number of reasons, including: Major changes in diet or alcohol intake.

What is the normal INR?

In healthy people an INR of 1.1 or below is considered normal. An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for disorders such as atrial fibrillation or a blood clot in the leg or lung.