Related Experiment Video

Updated: Mar 15, 2026

RNA-seq Analysis of Transcriptomes in Thrombin-treated and Control Human Pulmonary Microvascular Endothelial Cells
18:30

RNA-seq Analysis of Transcriptomes in Thrombin-treated and Control Human Pulmonary Microvascular Endothelial Cells

Published on: February 13, 2013

22.5K

Upstream versus downstream thrombin inhibition

Anouk J W Gulpen1,2, Arina J Ten Cate-Hoek1,3, Hugo Ten Cate1,2,3

  • 1a Department of Biochemistry , Maastricht University , Maastricht , The Netherlands.

Expert Review of Cardiovascular Therapy
|August 31, 2016
PubMed
Abstract

Insights

Vitamin K antagonists (VKA) and newer non-vitamin K anticoagulants (NOAC) manage thrombosis but carry bleeding risks. Factor XIa inhibitors represent a promising avenue for safer anticoagulation with fewer bleeding complications.

Area of Science:

  • Pharmacology
  • Cardiology
  • Hematology

Background:

  • Vitamin K antagonists (VKA) have long been standard for anticoagulation in atrial fibrillation and venous thromboembolism.
  • Non-vitamin K anticoagulants (NOAC) offer comparable efficacy and improved safety, particularly regarding intracranial bleeding.
  • Despite advances, major bleeding events persist, necessitating the development of safer anticoagulant therapies.

Purpose of the Study:

  • To review the current landscape of anticoagulation therapies.
  • To identify unmet needs in the management of non-vitamin K anticoagulants.
  • To explore the potential of novel anticoagulants, such as factor XIa inhibitors, for enhanced safety.

Main Methods:

  • Literature review of VKA and NOAC therapies.
  • Analysis of clinical trial data regarding efficacy and bleeding profiles.
  • Discussion of current challenges in NOAC management and future therapeutic directions.

Main Results:

  • NOACs are effective and safer than VKAs for preventing thrombosis but still associated with major bleeding.
  • Unmet needs in NOAC management include drug selection, dosing, and persistence.
  • Factor XIa inhibitors show potential for improved safety by reducing bleeding complications.

Conclusions:

  • Safer anticoagulation strategies are crucial for managing thrombotic disorders.
  • Factor XIa inhibitors represent a promising 'upstream' approach to anticoagulation.
  • Further research into factor XIa inhibitors may lead to reduced bleeding risks in patients requiring anticoagulation.
Keywords:
Anticoagulationfactor XIfactor XIInon-vitamin K antagonist oral anticoagulants (NOACs)vitamin K antagonists (VKA)

More Related Videos

Author Spotlight: Advancing Thrombolytic Testing by Integrating Flow Dynamics in In Vitro Models06:16

Author Spotlight: Advancing Thrombolytic Testing by Integrating Flow Dynamics in In Vitro Models

Published on: April 19, 2024

2.0K
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model09:42

A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model

Published on: June 4, 2021

3.6K

Related Concept Videos

Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
453
Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.2K
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.7K
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
1.5K
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
634
Clot Retraction and Fibrinolysis01:16

Clot Retraction and Fibrinolysis

After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
9.9K