May 22, 2024

Revolutionizing Care: The Impact of Anticoagulants on Thromboembolic Disorders

In this article, we will take a deep dive into understanding what anticoagulants are, how they work, common types of anticoagulants used, their benefits and risks.

What are Anticoagulants?
Anticoagulants are a class of medication that works to prevent or reduce coagulation of blood and formation of blood clots. Our blood normally exists in a liquid state inside our blood vessels but also has a natural ability to clot and form solid clots when needed to stop bleeding from a cut or injury. However, excess clotting inside blood vessels can be dangerous as it can restrict normal blood flow and oxygen supply to vital organs. This is where anticoagulants play an important role by interfering with the body’s natural clotting mechanism.

How do Anticoagulants Work?
Our blood contains clotting factors called platelets and proteins that work together in a chain reaction like manner to form blood clots when needed. Anticoagulants work at different points in the clotting cascade to prevent clots from forming or growing larger. Common targets of anticoagulants include inhibiting thrombin (Factor IIa), factor Xa, and platelets. By blocking these key proteins and cells involved in the clotting process, anticoagulants are able to maintain blood in a fluid state and prevent dangerous clots.

Common Types of Anticoagulants

One of the oldest and most commonly prescribed oral anticoagulant is warfarin. It works by inhibiting vitamin K and prevents the liver from producing certain clotting factors like Factor VII, Factor IX, Factor X, protein C, and protein S. It helps prevent clots from forming but comes with risk of bleeding and requires regular blood monitoring.

Heparin is usually given by injection under the skin or into veins. It works by activating antithrombin, a natural clot inhibiting protein in blood. This helps prevent formation of thrombin and factor Xa in the clotting cascade. Unfractionated heparin has a short duration of action while low molecular weight heparins like enoxaparin have longer effect.

Direct Oral Anticoagulants (DOACs)
In recent times, newer oral Anticoagulants s known as direct oral anticoagulants or target specific oral anticoagulants (TSOACs) have emerged which directly target specific points in the clotting cascade. Common DOACs include dabigatran (targeting thrombin), rivaroxaban, apixaban and edoxaban (targeting factor Xa). These have advantages of fixed dosing without blood monitoring but come with risks of bleeding.

Benefits of Anticoagulant Therapy

Reduces risk of stroke in atrial fibrillation patients
Prevents dangerous blood clots in deep veins of legs or lungs (deep vein thrombosis, pulmonary embolism)
Prevents clots in artificial heart valves or stents
Less risk of future heart attacks in certain heart conditions
Reduces complications of heart attacks and strokes

Risks Associated with Anticoagulant Therapy

Bleeding risks: Anticoagulants increase risk of internal bleeding in brain (hemorrhagic stroke), stomach, intestines etc. and external bleeding which can sometimes be life threatening.
Allergic reactions: Rare allergic reactions to anticoagulant medications are possible.
Over anticoagulation: Risk of bleeding increases significantly if anticoagulant dose or monitoring is not properly managed, especially with warfarin.
Drug interactions:some medications can interact with anticoagulants and affect clotting levels.

Anticoagulant therapy is hugely beneficial for preventing dangerous blood clots from forming in different conditions. However, risks of bleeding requiring close physician supervision and adherence to dosing make them a double-edged sword. Newer anticoagulants while offering more convenience also have bleeding risks. Overall, anticoagulants can be life-saving when prescribed and monitored carefully based on individual risks and benefits. More research continues to make them safer and more effective.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it