Author Affiliation: Vascular Research Laboratory,
Beth Israel Deaconess Hospital Medical Center, Boston, Mass.
Vitamin K (“Koagulation”) antagonists have been the sole
oral anticoagulants available for 60 years, ever since Link1 identified
the components in spoiled sweet clover responsible for bleeding in cattle.
Originally developed as a rat poison, vitamin K antagonists such as warfarin
are used successfully for the prevention of venous and arterial thromboembolism
for a wide range of clinical indications, including atrial fibrillation (AF),
venous thromboembolism (VTE), coronary artery disease, some orthopedic procedures,
and congenital or acquired thrombophilia. Since both age and obesity increase
the risk of atrial fibrillation2 and VTE, the
need for anticoagulants is increasing.
Gurewich V. Ximelagatran—Promises and Concerns. JAMA. 2005;293(6):736–739. doi:10.1001/jama.293.6.736