Another indication for VKA, CrCl <30 mL/min, liver disease, bacterial endocarditis, contraindications for anticoagulant treatment, systolic blood pressure >180 mmHg or diastolic blood pressure >110, childbearing potential without proper contraceptive measures, pregnancy or breast feeding, concomitant use of strong cytochrome P450 3A4 inhibitors, bacterial endocarditis. This evidence concerns the gene CYP3A4 and liver disorder.