https://doi.org/10.4081/btvb.2025.169
The introduction of the international normalized ratio as a breakthrough event in the history of thrombosis
Published: 23 January 2025
Abstract Views: 36
PDF: 10
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Very few among the youngest readers of this Journal would think about the introduction of the international normalized ratio (INR) as a breakthrough event in the history of thrombosis...
1. Fenske TK. The president who swallowed rat poison preventing the next heart attack. Patient Care 2004;15:44-53.
2. Poller L, Taberner DA. Dosage and control of oral anticoagulants: an international collaborative survey. Br J Haematol 1982;51:479-85.
DOI: https://doi.org/10.1111/j.1365-2141.1982.00479.x
3. Poller l. Standardization of anticoagulant treatment: the Manchester regional thromboplastin scheme. Br Med J 1964;2:565-6.
DOI: https://doi.org/10.1136/bmj.2.5408.565
4. Poller L. International normalized ratios (INR): the first 20 years. J Thromb Haemost 2004;2:849-60.
DOI: https://doi.org/10.1111/j.1538-7836.2004.00775.x
5. Kirkwood T. Calibration of reference thromboplastins and standardization of the prothrombin time ratio. Thromb Haemost 1983;50:238-44.
DOI: https://doi.org/10.1055/s-0038-1657371
6. Chantarangkul V, Tripodi A, van den Besselaar AMHP. Guidelines for thromboplastins and plasma used to control oral anticoagulant therapy with vitamin K antagonists. WHO Technical Report Series 2013; No.979:273-305.
7. van den Besselaar AMHP, Stavelin A, Kitchen S, et al. Defining a metrologically traceable and sustainable calibration hierarchy of international normalized ratio for monitoring of vitamin K antagonist treatment in accordance with International Organization for Standardization (ISO) 17511:2020 standard: communication from the International Federation of Clinical Chemistry and Laboratory Medicine-SSC/ISTH working group on prothrombin time/international normalized ratio standardization. J Thromb Haemost 2024;22:1236-48.
DOI: https://doi.org/10.1016/j.jtha.2023.12.013
8. Tripodi A, Scalambrino E, Clerici M, et al. Thromboplastin calibration revisited to look for possible revision of the World Health Organization recommendations. J Thromb Haemost. 2023;21:311-16.
DOI: https://doi.org/10.1016/j.jtha.2022.11.016
9. van den Besselaar AM. Multi-center study of replacement of the international reference preparation for thromboplastin, rabbit, plain. Thromb Haemost 1993;70:794-9.
DOI: https://doi.org/10.1055/s-0038-1649672
10. Chantarangkul V, van den Besselaar AM, Witteveen E, et al. International collaborative study for the calibration of a proposed international standard for thromboplastin, rabbit, plain. J Thromb Haemost 2006;4:1339-45.
DOI: https://doi.org/10.1111/j.1538-7836.2006.01910.x
11. van den Besselaar AMHP, Chantarangkul V, Angeloni F, et al. International collaborative study for the calibration of proposed International Standards for thromboplastin, rabbit, plain, and for thromboplastin, recombinant, human, plain. J Thromb Haemost 2018;16:142-9.
DOI: https://doi.org/10.1111/jth.13879
12. Tripodi A, Chantarangkul V, Van Den Besselaar AM, et al. International collaborative study for the calibration of a proposed international standard for thromboplastin, human, plain. J Thromb Haemost 2010;8:2066-8.
DOI: https://doi.org/10.1111/j.1538-7836.2010.03980.x
13. Tripodi A, Chantarangkul V, Clerici M, et al. Determination of the International Sensitivity Index of a new near-patient testing device to monitor oral anticoagulant therapy--overview of the assessment of conformity to the calibration model. Thromb Haemost 1997;78:855-8.
DOI: https://doi.org/10.1055/s-0038-1657641
14. Tripodi A, Chantarangkul V, Primignani M, et al. The international normalized ratio calibrated for cirrhosis (INR(liver)) normalizes prothrombin time results for model for end-stage liver disease calculation. Hepatology 2007;46:520-7.
DOI: https://doi.org/10.1002/hep.21732
15. Raza S, Pinkerton P, Hirsh J, et al. The historical origins of modern international normalized ratio targets. J Thromb Haemost 2024;22:2184-94.
DOI: https://doi.org/10.1016/j.jtha.2024.05.013
Supporting Agencies
Italian Ministry of HealthHow to Cite
Tripodi, A. (2025). The introduction of the international normalized ratio as a breakthrough event in the history of thrombosis. Bleeding, Thrombosis and Vascular Biology, 4(1). https://doi.org/10.4081/btvb.2025.169
Copyright (c) 2025 The Author(s)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Most read articles by the same author(s)
- Niccolò Bitto, Vincenzo La Mura, Anna Ludovica Fracanzani, Armando Tripodi, Is non-alcoholic fatty liver disease a prothrombotic risk factor? , Bleeding, Thrombosis and Vascular Biology: Vol. 2 No. 2 (2023)
- Armando Tripodi, Remembering the XXVI SISET Congress and the 50th anniversary of its foundation, 2020 , Bleeding, Thrombosis and Vascular Biology: Vol. 4 No. 1 (2025)
Similar Articles
- Gualtiero Palareti, Paolo Prandoni, Cristina Legnani, Emilia Antonucci, Serena Zorzi, Alberto Tosetto, Lorenza Bertù, Sophie Testa, Vittorio Pengo, Walter Ageno, Ida Martinelli, Benilde Cosmi, Eugenio Bucherini, Daniela Poli, Rationale and design of a study on D-dimer use to stratify patients after a first unprovoked venous thromboembolism for their risk of recurrence: extended low-dose Apixaban given only to patients with positive D-dimer results , Bleeding, Thrombosis and Vascular Biology: Vol. 1 No. 1 (2022)
- Yishi Tan, Marc Carrier, Nicola Curry, Michael Desborough, Kathryn Musgrave, Marie Scully, Tzu-Fei Wang, Mari Thomas, Simon J. Stanworth, Cancer complicated by thrombosis and thrombocytopenia: still a therapeutic dilemma , Bleeding, Thrombosis and Vascular Biology: Vol. 3 No. s1 (2024): 12th ICTHIC
- Domenico Prisco, Irene Mattioli, Raffaele De Caterina, Alessandra Bettiol, The new era of anticoagulation: factor XI and XII inhibitors , Bleeding, Thrombosis and Vascular Biology: Vol. 2 No. 2 (2023)
- Daniela Poli, Emilia Antonucci, Gualtiero Palareti, Roberto Facchinetti, Pietro Falco, Giuseppina Serricchio, Teresa Lerede, Lucilla Masciocco, Paolo Gresele, Sophie Testa, Major bleedings in mechanical prosthetic heart valves patients on Vitamin K antagonist treatment. Data from the PLECTRUM Study , Bleeding, Thrombosis and Vascular Biology: Vol. 1 No. 2 (2022)
- Lisa Pieri, Silvia Linari, Francesca Salvianti, Monica Attanasio, Giancarlo Castaman, Impaired platelet function in Hermansky-Pudlak syndrome associated with novel mutations in HPS3, HPS6 and HPS8 genes , Bleeding, Thrombosis and Vascular Biology: Vol. 3 No. 3 (2024)
- Daniela Poli, Walter Ageno, Emilia Antonucci, Salvatore Bradamante, Eugenio Bucherini, Paolo Chiarugi, Antonio Chistolini, Benilde Cosmi, Anna Falanga, Antonio Insana, Domenico Lione, Rosa Maria Lombardi, Giuseppe Malcangi, Rossella Marcucci, Giuliana Martini, Lucilla Masciocco, Carmelo Paparo, Daniele Pastori, Simona Pedrini, Vittorio Pengo, Pasquale Pignatelli, Andrea Toma, Sophie Testa, Gualtiero Palareti, Management of anticoagulation in atrial fibrillation patients in Italy: insight from the Atrial Fibrillation-Survey on Anticoagulated Patients Register (AF-START) , Bleeding, Thrombosis and Vascular Biology: Vol. 2 No. 2 (2023)
- Giovanni L. Tiscia, Donatella Colaizzo, Antonio De Laurenzo, Filomena Cappucci, Lucia Fischetti, Elena Chinni, Mario Mastroianno, Giovanni Favuzzi, Massimo Carella, Elvira Grandone, Thrombin generation assay in COVID-19 patients shows a hypocoagulable pattern , Bleeding, Thrombosis and Vascular Biology: Vol. 3 No. 3 (2024)
- Sergio Coccheri, A re-appraisal of thrombogenesis in COVID-19, seen as a multiple "Complex system" , Bleeding, Thrombosis and Vascular Biology: Vol. 1 No. 3 (2022)
- Cristina Legnani, Michela Cini, Sophie Testa, Alberto Tosetto, Claudia Dellanoce, Stefania Bellesso, Giuseppe Carli, Ilaria Nichele, Laura Lissandrini, Serena Zorzi, Emilia Antonucci, Gualtiero Palareti, Evaluation of Coaguchek®Pro II coagulation testing device performance to assess direct oral anticoagulant action. The DOAC-CHECK study , Bleeding, Thrombosis and Vascular Biology: Vol. 1 No. 3 (2022)
- Gianfranco De Girolamo, Luca Sarti, Sonia Cecoli, Karin Bonora, Chiara Ajolfi, Francesco Bellelli, Valeria Coluccio, Gualtiero Palareti, Marco Marietta, Safety and efficacy of treatment with vitamin K antagonists in patients managed in a network of anticoagulation services or as routine general care , Bleeding, Thrombosis and Vascular Biology: Vol. 1 No. 1 (2022)
You may also start an advanced similarity search for this article.
