Eighty years of oral anticoagulation: Learning from history

In the year 2021 we celebrate the 80th anniversary of the first clinical use of vitamin K antagonists (VKAs), the mainstay of prevention and long-term treatment of thromboembolic disease. The discovery and development of oral anticoagulants is one of the most important chapters in the history of med...

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Bibliographic Details
Published in:Vascular pharmacology 2021-12, Vol.141, p.106918-106918, Article 106918
Main Authors: Montinari, Maria Rosa, Minelli, Sergio, De Caterina, Raffaele
Format: Article
Language:English
Subjects:
Administration, Oral
Antagonists
Anticoagulants
Atrial Fibrillation - drug therapy
Clinical trials
Coagulation factors
Hemorrhage - chemically induced
History of medicine
Humans
Non-vitamin K antagonist oral anticoagulants: NOACs
Oral anticoagulants
Phylloquinone
Physicians
Stroke - prevention & control
Thromboembolism
Thrombosis
Vitamin K
Vitamin K antagonists
VKAs
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Summary:In the year 2021 we celebrate the 80th anniversary of the first clinical use of vitamin K antagonists (VKAs), the mainstay of prevention and long-term treatment of thromboembolic disease. The discovery and development of oral anticoagulants is one of the most important chapters in the history of medicine, a goal pursued by physicians trying to combat the clinical manifestations of thrombosis since ancient times. Until the last decade, VKAs were the only oral anticoagulants available and used in clinical practice. Today, their clinical use has progressively shrunk, as the non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly replacing VKAs in various conditions after the successful completion of several large randomized controlled trials. Currently, new research is tackling upstream components of the intrinsic pathway — particularly factor XI and factor XII — for the development of new, even safer anticoagulants promising to reduce bleeding without compromising efficacy. This review highlights the evolution of oral anticoagulant therapy tracing the key stages of a long and fascinating history that has unfolded from the first part of the twentieth century until today, indeed an intriguing journey where serendipity is intertwined with the tenacious work of many researchers. [Display omitted]
ISSN:1537-1891
1879-3649
DOI:10.1016/j.vph.2021.106918