The Point-of-Care INR Test for Vitamin K Antagonist Monitoring

Abstract
A 59-year-old man who had been taking warfarin for 16 years for recurrent deep vein thrombosis and a left ventricular thrombosis presented to the anticoagulation management service for a follow-up visit. His warfarin had been managed via point-of-care (POC) testing for the past 4 years with a goal international normalized ratio (INR) of 2.0 to 3.0. On presentation, his POC INR was 3.7. He reported no extra warfarin doses, medication changes, dietary nonadherence, or bleeding. His warfarin dosage was 36 mg/wk (3 mg every Wednesday and Saturday and 6 mg all other days) for the past year. The Table shows the patient’s laboratory test results.