What is the recommended individual TTR when using VKAs to manage AF?
Clinical guidelines on the management of AF advocate an individual TTR of at least 65% in order to maximize efficacy and safety. An analysis of anticoagulation control in the Global Anticoagulation Registry in the Field (GARFIELD-AF) registry (n 9,934) revealed that only 41.1% had TTR $ 65%, and of all the INR values, only 51.4% were in the therapeutic range (INR, 2.0 to 3.0). An analysis of individual TTR from Swedish registries (n 40,449) revealed an overall mean individual TTR of 68.6% and significantly lower annual rates of thromboembolism (2.37% vs 4.41%), all-cause mortality when individual TTR was $ 70% compared with individual TTR < 70%, respectively. Therefore, when VKAs are used, attention should be focused on the average individual TTR as a measure of the quality of anticoagulation control, and the recommended individual TTR should be at least 65%. 