Anticoagulation

Anticoagulation is treatment that reduces blood clot formation by interfering with the coagulation system. It helps prevent or treat harmful clots without directly dissolving clots that have already formed.

Coagulation cascade: A sequence of enzymatic reactions that generates thrombin and forms a fibrin clot. Anticoagulants reduce clotting by targeting reactions within this sequence.
Atrial fibrillation: An irregular heart rhythm that can allow blood to pool in the atria and form clots. Anticoagulation can reduce the risk of stroke from atrial-fibrillation-related clots.
Antiplatelet therapy: Treatment that reduces platelet activation or aggregation to prevent arterial clots. It targets platelets rather than the coagulation enzymes targeted by anticoagulants.
Heparin: An anticoagulant drug that enhances antithrombin-mediated inhibition of coagulation factors. It acts rapidly and is used when closely adjustable anticoagulation is needed.
Anticoagulant-related bleeding: Bleeding that occurs as an adverse effect of anticoagulant treatment. It is the principal harm weighed against the benefit of preventing thrombosis.
Thrombin: An enzyme that converts fibrinogen into fibrin and activates several clotting factors. Direct thrombin inhibitors block this enzyme's central role in clot formation.
Venous thromboembolism: Blood clots in the veins, including deep vein thrombosis and pulmonary embolism. Anticoagulants treat acute venous clots and help prevent recurrence.
Thrombolytic therapy: Treatment that activates clot breakdown to rapidly dissolve an existing thrombus. It can dissolve established clots, whereas anticoagulation mainly prevents growth and new formation.
Warfarin: An oral anticoagulant that inhibits vitamin K recycling and reduces functional clotting factors. Its effect develops gradually and is monitored with the international normalized ratio.
Reversal of anticoagulation: Measures that reduce or counter anticoagulant effects during serious bleeding or urgent procedures. Specific reversal strategies depend on the drug and the urgency of the situation.

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