INR Range?

[mitchhollar]

I just received a St. Jude Aortic valve on March 24th. My surgeon wants my INR to be 1.8 to 2.5. Does that sound right to everyone here? I have been looking around a lot and feel like that might be low. How do they determine where you need to be? Thanks for any help.

 

[AgilityDog]

My understanding is the range for a mechanical aortic is 2.0 to 3.0 1.8 to 2.5 is a narrow, and low, range. It's very difficult to keep to such a narrow range.
If you have a tissue valve, however, you may be anticoagluated for only a few months. I think that range is still 2.0 to 3.0. I'm not certain.
Check with your cardiologist, too.

 

[catwoman]

Mitch:

It's unusual for a surgeon to set or suggest the INR range for a valver. Usually, the doctor who will be following our long-term care -- our PCP, internist or cardiologist -- sets the INR range.

The range that's normally set for an aortic valve replacement is 2.0 to 3.0.

 

[ALCapshaw2]

The "usual" INR guidelines for a Mechanical Aortic Valve are 2.0 to 3.0 as others have indicated.

By recommending a range that dips below 2.0, your surgeon would seem to be exhibiting a greater Fear of Bleeding than concern for the enhanced risk of STROKE.

I concur with 'Catwoman's' recommendation to discuss your range with whoever is going to be overseeing your anti-coagulation management.

An INR of 2.5 provides the 'lowest overall risk' since that is where the Stroke Risk curve intersects the Bleeding Risk curve. Graphs that I have seen show a more rapid increase in Stroke Risk below 2.0 and a more rapid increase in Bleeding Risk above 5.0

Patients who are at elevated risk of Stroke (history of stroke, TIA, or who have a Mechanical Valve in the Mitral Position) are usually advised to use a target range of 2.5 to 3.5, sometimes even 3.0 to 4.0.

One of the "Famous Sayings" on VR.com is that
"It is easier to replace Blood Cells than to replace Brain Cells".
For that reason, many of our members prefer to be on the High Side of their recommended range.

'AL Capshaw'

 

[Bina]

I also have a St. Jude AVR..... My surgeon recommended an INR range of 2.5----3.5
Staying around 3.1 has served me well so far.
Going under 2.0 just isn't very safe, unless you like life on the edge.

 

[Cameron]

I have an On-X aortic valve and I was told at the hospital that the INR range was 2.0-3.0. When I saw my Internist for my follow up he said he would prefer that I use a range of 2.5-3.5, which was where I wanted to be on the blood cell/brain cell curve anyway. I have been wobbling around 2.6-2.8 and am currently on a campaign to get me up to around the 3.0 mark consistently. The way I look at it you have some control over any bleeding incident whereas a clotting incident is completely internal and out of your control. Given that the INR readings can be something like 0.2 or more off, I am more comfy keeping 2.5 as my low boundary.
Cameron

 

[Ross]

 

[Bina]

Ross, that table is great. Is it posted somewhere here on the site? It would be a good sticky.

 

[Ross]

Ross, that table is great. Is it posted somewhere here on the site? It would be a good sticky.

It's available in the must have reference links:

http://www.aafp.org/afp/990201ap/635.html

 

[EVELYN]

Tyce's surgeon told him he wanted to keep him between 2.5 and 3.5.....AVR St. Jude's 2002.

Evelyn

 

[netmiff]

My INR range was set at 2.0 - 3.0, but I negotiated and got it changed to 2.5 - 3.5. Although there is a history of bleeding stroke on the female side of my mother's family (and I am one, too), I prefer higher than lower, too. Hae been relatively consistent at 3.0 - 3.5 over the last few months, now that there have been no changes to my other meds for a while.