From the Research
The therapeutic INR range for patients with mitral valve repair is typically 2.0-3.0, as supported by the most recent study 1 published in 2020, which found that an INR goal of 2.5 was associated with a reduced composite of bleeding and thromboembolic complications. This range applies to patients who require anticoagulation therapy with warfarin (Coumadin) following their procedure. However, not all mitral valve repair patients need long-term anticoagulation. The need for anticoagulation depends on several factors including:
- The presence of atrial fibrillation
- The type of repair performed
- Whether a prosthetic ring was implanted Patients with mechanical mitral valve replacements require a higher INR target of 2.5-3.5, but this is different from a repair. Regular INR monitoring is essential to maintain the therapeutic range and prevent complications. Too low an INR increases the risk of thromboembolism, while too high an INR increases bleeding risk. Factors like diet, medications, and alcohol consumption can affect INR levels, so patients should maintain consistent vitamin K intake and inform healthcare providers about any medication changes. It's worth noting that more recent studies, such as 2, have explored the use of alternative anticoagulants like apixaban, but the therapeutic INR range for warfarin remains a crucial consideration for patients with mitral valve repair. Additionally, studies like 3 and 4 have investigated the use of anticoagulants in patients with atrial fibrillation and mitral valve repair, but the primary focus remains on maintaining an optimal INR range to minimize the risk of complications. Overall, the therapeutic INR range of 2.0-3.0 remains the standard for patients with mitral valve repair, as supported by the most recent and highest-quality evidence 1.