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Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

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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...
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Venous Thrombosis III: Interprofessional Care01:29

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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...
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Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

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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...
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Disorders of Hemostasis01:24

Disorders of Hemostasis

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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
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Venous Thrombosis IV: Nursing Management01:30

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

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

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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.
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Updated: Sep 24, 2025

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Over-anticoagulation by vitamin K antagonists and gender differences.

D Barcellona1, P Schirru2, A Mameli2

  • 1Department of Medical Science and Public Health, University of Cagliari, Italy.

International Journal of Cardiology
|May 9, 2022
PubMed
Summary

Female patients experience more over-anticoagulation episodes with vitamin K antagonists (VKAs), potentially explaining lower time in therapeutic range (TTR). However, this excess anticoagulation was not linked to increased bleeding events.

Keywords:
AcenocoumarolBleedingFemale genderOverdoses, male genderWarfarin

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Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Lower time in therapeutic range (TTR) in females on vitamin K antagonists (VKAs) is documented.
  • This study investigates over-anticoagulation, gender, VKA type, indications, TTR, and bleeding risk.

Purpose of the Study:

  • To evaluate the association between gender and over-anticoagulation in patients on VKAs.
  • To determine factors influencing over-anticoagulation episodes and their relationship with TTR and bleeding.

Main Methods:

  • Retrospective analysis of 1230 patients with venous thromboembolism or atrial fibrillation from Dec 2000 to Jan 2004.
  • Collected data on age, gender, VKA type, indications, INR, bleeding events, and calculated TTR.

Main Results:

  • Females had a significantly higher median number of over-anticoagulation episodes per year (0.39) compared to males (0.28).
  • Over-anticoagulation episodes were associated with female gender, atrial fibrillation, warfarin, longer follow-up, and TTR <73%.
  • No association was found between over-anticoagulation episodes and bleeding events.

Conclusions:

  • Higher over-anticoagulation in females may explain their lower TTR.
  • Excess anticoagulation did not correlate with increased bleeding risk.
  • Acenocoumarol showed better INR recovery than warfarin, suggesting it as a potential alternative for patients with frequent over-anticoagulation.