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Heghine Khachatryan: Less Frequent INR Monitoring – Does It Necessarily Mean Poorer Anticoagulation Control?
Heghine Khachatryan/LinkedIn
Aug 9, 2026, 07:32

Heghine Khachatryan: Less Frequent INR Monitoring – Does It Necessarily Mean Poorer Anticoagulation Control?

Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared Thrombosis Update’s post on LinkedIn:

“Less frequent INR monitoring — does it necessarily mean poorer anticoagulation control?

An important real-world observation from a Dutch dynamic cohort study published in Thrombosis Update challenges an assumption deeply embedded in VKA management: that reducing INR testing frequency will inevitably compromise anticoagulation stability.

During the COVID-19 pandemic, INR monitoring became less frequent compared with the pre-pandemic period. Yet, importantly, this temporary reduction did not appear to impair VKA stability.

The message is nuanced.

Regular INR monitoring remains a cornerstone of safe and effective vitamin K antagonist therapy. However, in appropriately selected, clinically stable patients, the optimal monitoring strategy may be more individualized than a rigid testing schedule suggests.

For me, the broader lesson extends beyond the pandemic:

Good anticoagulation management is not simply about how often we measure INR—it is about identifying when monitoring adds meaningful clinical value and adapting follow-up to the stability and risk profile of the individual patient.

This raises an interesting question for contemporary anticoagulation practice:
Can we move from fixed INR-monitoring intervals toward more personalized, risk-adapted monitoring strategies in stable VKA-treated patients?”

Thrombosis Update shared a post on LinkedIn about a recent article by Tessa Elling et al., adding:

“This dutch dynamic cohort study in Thrombosis Update reported decreased INR testing frequency during the COVID19 compared with the pre-pandemic period.

Here is the link of the the associated editorial commentary.”

Title: Impact of reduced INR monitoring frequency on anticoagulation control during the COVID-19 pandemic: A dutch dynamic cohort study

Authors: Tessa Elling, Nic J.G.M. Veeger, Derk Hardeman, Adrian Kruit, Jos G.J. Pouwels, Jenneke Stegeman, Vladimir Tichelaar, Karina Meijer

Heghine Khachatryan

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Adrian Kruit Derk Hardeman Health Heghine Khachatryan Hematology Hemostasis Hemostasis News Hemostasis Today Jenneke Stegeman Jos G.J. Pouwels Karina Meijer Medicine Nic J.G.M. Veeger Tessa Elling Thrombosis Update Vladimir Tichelaar
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