Lower versus Standard INR Targets in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Review of 74 RCTs (n=11,322) found that compared with standard INR target (2-3), lower INR ranges (1.5-2) were associated with higher rates of thromboembolism (7.1% vs 4.4%), lower rates of major bleeding (2.2.vs. 4.4%), and similar mortality rates (4.8 v 5.2%).

SPS commentary:

The researchers also note that the lower INR target data were predominantly based on RCTs performed in Eastern Asia, and therefore generalisability to Western populations may be limited. Until higher quality data demonstrate otherwise, an INR range of 2 to 3 should remain standard for thromboembolic prophylaxis in AF.

Thrombosis and Haemostasis