Abstract
The optimal INR target with vitamin K antagonist (VKA) therapy in patients with mechanical heart valves is unclear. Although higher INR targets are often used in Western countries, data from randomized controlled trials (RCTs) have suggested that lower INR targets may offer reduced bleeding rates without a significant difference in thromboembolic rates. Lower INR targets are frequently used in East-Asia. The objective of this systematic review and meta-analysis was to evaluate the effects of lower versus higher INR targets in Western and East-Asian populations on rates of thromboembolism and bleeding in left-sided mechanical heart valve patients.
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