Abstract
Vitamin K antagonists (VKAs), such as warfarin, are oral anticoagulants used to treat and prevent pulmonary embolism, deep vein thrombosis, and complications associated with atrial fibrillation and heart valve replacement. VKAs are effective against blood clotting where blood flow is relatively slow, such as in veins, in dysfunctional atria, and behind heart valves. These drugs, however, have a narrow therapeutic window and require frequent anticoagulation monitoring and dose adjustments. To overcome these problems, direct oral anticoagulants (DOACs) targeting factor Xa and thrombin have been developed, with the advantages of less monitoring, fixed dosing, predictable responses, and fewer food interactions.
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