Table 9.

—[Section 4.1.1] Optimal Therapeutic INR Range: Higher Target vs 2 to 3¹¹⁹

Outcomes	No. of Participants, (Studies) Follow-up	Quality of the Evidence (GRADE)	Relative Effect (95% CI)	Anticipated Absolute Effectsa
				Risk With INR 2-3	Risk Difference With INR 3-5 (95% CI)
Major hemorrhage per 100 patient-y, various definitions	76,646 (17 studiesb), 1.8 y	Lowc,d due to risk of bias, dose-response gradient	RR 2.7 (1.8-3.9)	6 per 1,000	10 more per 1,000 (from 5 more to 17 more)
Thromboembolism per 100 patient-y, various definitions	835 (10 studiese)	Very lowf,g due to risk of bias, inconsistency	RR 0.9 (0.6-1.3)	Study population
				46 per 1,000	5 fewer per 1,000 (from 18 fewer to 14 more)
				Moderate
				50 per 1,000	5 fewer per 1,000 (from 20 fewer to 15 more)

See Table 1-3 legends for expansion of abbreviations.

^aTime frame in days to months.

^bSix studies had a randomized controlled trial design.

^cThe majority of studies (eight) were retrospective cohorts.

^dIt is biologically plausible that with increased intensity there will be more bleeding.

^eOne study had a randomized control design.

^fThree of four studies had a retrospective cohort design.

^gThromboembolic events were more frequent with an INR of 2 to 3 in two studies, less frequent in one study, and similar in one study.