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Anticoagulants, oral (vitamin K antagonists-VKA)

Specialities: Angiology - Vascular medicine · Cardiology - Cardiovascular medicine · Family medicine · Forensic medicine/pathology · General Practice · ICU - I.C.U. · Veterinary medicine and pathology

Therapeutic oral vitamin K antagonists (VKA) acenocoumarol, coumadin, coumarin, phenprocoumon, warfarin and the like. See also under the rodenticide/pesticides brodifacoum, diphacinone, diphenadione. See also under other anticoagulants heparin, thrombolytic agents, platelet glycoprotein aggregation inhibitors (anti-GPIIB/IIIA) (abciximab, ticlopidine, clopidogrel, eptifibatide) and direct (new) anti-IIa or anti-Xa oral anticoagulans (apixaban, dabigatran, rivaroxaban). Patients with pulmonary hypertension who receive oral anticoagulants are also at risk of hemorrhage in the chest and/or other organs. Drug abusers may surreptitiously take warfarin to prevent femoral vein thrombosis. Abused drugs and the smoke of certain cigarettes may contain coumarin or warfarin, causing coagulopathy (PMID 11547737, 17583404, 24275169). Antidotes and reversal agents: PMID 24275169, 26872887.

Frequency - Incidence

Incidence of cardiac adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for cardiac adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic