Recommended Therapeutic INR Range for Patients with Antiphospholipid Syndrome on Warfarin Anticoagulation: Is Moderate-Intensity (INR 2.0 - 3.0) or High-Intensity (INR 3.1 - 4.0) Better for Reducing Risk of Recurrent Thromboembolic Events?
نویسندگان
چکیده
Patients with antiphospholipid syndrome (APS) are at increased risk of recurrent thromboembolic events due to the pathology of the disease. While prolonged anticoagulation is the treatment of choice for patients with thrombosis, much debate remains about the optimum intensity of anticoagulation. Anticoagulation with warfarin has been shown to decrease rates of thrombosis recurrence, but definitive evidence regarding targeted therapy to an INR of moderate (2.0 - 3.0) or high (3.1 - 4.0) intensity is lacking.
منابع مشابه
A randomized clinical trial of high-intensity warfarin vs. conventional antithrombotic therapy for the prevention of recurrent thrombosis in patients with the antiphospholipid syndrome (WAPS).
BACKGROUND The optimal intensity of oral anticoagulation for the prevention of recurrent thrombosis in patients with antiphospholipid antibody syndrome is uncertain. Retrospective studies show that only high-intensity oral anticoagulation [target international normalized ratio (INR) >3.0] is effective but a recent randomized clinical trial comparing high (INR range 3.0-4.0) vs. moderate (INR 2....
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The antiphospholipid syndrome is an antibody-mediated hypercoagulable state characterized by recurrent venous and arterial thromboembolic events. Several studies have determined that the frequency of antiphospholipid syndrome in patients presenting with a venous thromboembolic event is between 4% and 14%. Because of the high risk for recurrent thromboembolism in these patients, current recommen...
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OBJECTIVE To systematically review the efficacy and safety data of different therapeutic approaches in patients with antiphospholipid antibodies (aPL) and thrombosis. METHODS The Medline database and references from selected reports and review articles were used. Randomized controlled trials, prospective and retrospective cohort studies, and subgroup analysis (n > 15) that focused on the seco...
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further validation. It highlights the difficulty of maintaining a narrow therapeutic target INR range with warfarin despite the best intentions. Given the limitations of the published studies, the clinician is still faced with uncertainty in dealing with patients with thrombosis and antiphospholipid antibodies. For most people with thrombosis and antiphospholipid antibodies, long-term standard-...
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BACKGROUND Maintaining stable levels of anticoagulation using warfarin therapy is challenging. Few studies have examined the stability of the international normalized ratio (INR) in patients with nonvalvular atrial fibrillation (NVAF) who have had ≥6 months' exposure to warfarin anticoagulation for stroke prevention. OBJECTIVE Our objective was to describe INR control in NVAF patients who had...
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عنوان ژورنال:
دوره 8 شماره
صفحات -
تاریخ انتشار 2016