Hi Thanks for posting query CVT in25 year old person may be due to hypercoagulable state ( abnormal increase tendency of blood to form clot) by looking at your tests report it seems you have not completely evaluated for hypercoagulable state. Of course increase homocysteine level is associated with hypercoagulability but it level may increase in the presence of Low Vit B12. There set of test we use to work up to hypercoagulable state- Apart from homocysteine level are ANA, proein C, ProteinS, factor V Leiden, Antithrombin III, Lupus anticoagulant, Antiphospholipid antibodies Depending upon cause further treatment will be planned I am not able to understand why you stopped INR. By giving Acitrome we target INR in the range of 2-3 which is abnormal when you look at the lab report range (1-1.5) but to achieve this abnormality is target of treatment. Once Acitrome is started it should be discontinued only when we are certain episode of clot formation is temporarily phenomena not a permanent hypercoagulable state. Discuss with your treating doctor According to your lab reports there are risk factor for heart attack (that does not mean you will definitively have) and hypercoagulable state will add to problem Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Dr Jeetendra Sharma Senior Consultant Critical care Medicine.