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Daniel E. Singer, MD; Margaret C. Fang, MD, MPH; Alan S. Go, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Torn et al¹ conclude that the target international normalized ratio (INR) for atrial fibrillation (AF) should be 3.0 to 3.4, rather than the standard INR range of 2.0 to 3.0,² based on a Leiden Thrombosis Centre cohort observed from 1994 to 1998. We believe that their data do not support their conclusion.

Precisely comparing the efficacy of adjacent INR intervals demands large numbers of relevant outcome events. Even if one accepts all the events reported by Torn et al¹ as relevant, the total number is too small. The confidence intervals of crude incidence rates across INR intervals from 2.0 through 3.5 highly overlap. We found no assertion that an INR range of 3.0 to 3.4 was statistically significantly different from lower INR intervals. Furthermore, as the authors acknowledge, patients with AF are anticoagulated to prevent ischemic strokes. . . . [Full Text of this Article]

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