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
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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.
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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
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