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Difference Between Anticoagulants and Antiplatelets
Anticoagulants and antiplatelets are two types of drugs that are commonly used to prevent and treat blood clots. While both medications aim to reduce the risk of blood clot formation, they work through different mechanisms and have different indications, contraindications, and side effects.
What are Anticoagulants?
Anticoagulants are drugs that prevent blood from clotting by inhibiting the activity of certain clotting factors in the blood. They are typically used to treat and prevent blood clots in the veins and arteries, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke. Anticoagulants are also used to prevent blood clots in individuals with certain medical conditions that increase the risk of clot formation, such as atrial fibrillation (AFib), heart valve replacement, and cancer.
The most commonly used anticoagulants are warfarin and the newer direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban, apixaban, and edoxaban. Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting factors in the liver, while DOACs directly inhibit the activity of certain clotting factors in the blood. Anticoagulants are typically taken orally and require careful monitoring of blood clotting levels (measured by the international normalized ratio, or INR) to ensure that the dosage is appropriate and to minimize the risk of bleeding.
Uses − The anticoagulants are used to help stop blood clots from forming in the body. Therefore, these medications are used to treat medical conditions like a deep-vein thrombosis (DVT). The problem with DVT is that it can lead to a clot breaking off and traveling to the lungs, which can often lead to death. People with clots that have been found to form in the coronary arteries of the heart can also benefit from an anticoagulant medication. These coronary artery clots are likely to lead to a heart attack and death. Patients with atrial fibrillation are also at increased risk of blood clots and also are often prescribed anticoagulants.
Side effects − Side effects from anticoagulants include causing too high of a blood potassium level, and sometimes thrombocytopenia. The thrombocytopenia is when there are too few blood platelets present, which happens because sometimes the heparin causes the person’s immune system to attack them. Excess bleeding is also a possibility when these medicines are given,particularly with heparin. Warfarin is a medicine that has the side effect of bleeding and bruising, and it can cause gastrointestinal upset.
Examples − Dicoumarin is an example of an anticoagulant along with heparin. The heparin has a much faster effect than the dicoumarin which takes time to work, and heparin has to be given intravenously. Warfarin is an example of an anticoagulant that can be taken orally by patients. Other examples of anticoagulants include ivaroxaban and dabigatran.
What are Antiplatelets?
Antiplatelets are drugs that prevent blood clots by inhibiting the activation of platelets, which are small blood cells that play a key role in clot formation. They are commonly used to prevent blood clots in individuals with cardiovascular disease, such as those with a history of heart attack, unstable angina, or peripheral artery disease. Antiplatelets are also used to prevent blood clots in individuals who have undergone certain medical procedures, such as coronary artery bypass graft surgery or placement of a stent.
The most commonly used antiplatelets are aspirin, clopidogrel, and ticagrelor. Aspirin works by inhibiting the production of thromboxane A2, a chemical that promotes platelet activation and aggregation. Clopidogrel and ticagrelor work by inhibiting the binding of adenosine diphosphate (ADP) to platelet receptors, which prevents platelet activation and aggregation.
Antiplatelets are typically taken orally and do not require monitoring of blood clotting levels, but they may increase the risk of bleeding, especially in individuals who undergo surgery or have a history of bleeding disorders.
Uses − Antiplatelet drugs are sometimes given to patients who are having a heart attack because it is believed that these medicines can help to decrease myocardial damage to the heart. These medications are often prescribed for people who have had a history of ischemic strokes, coronary artery disease, heart attack or peripheral artery problems. They can also be prescribed for people who have had heart valve surgery, bypass surgery, or stents placed in arteries.
Side effects − Side effects of antiplatelet medicines can include bruising, excessive bleeding (including from the digestive system), gastrointestinal upset, dizziness and sometimes a rash.
Examples − Examples of antiplatelet medications include tirofiban, eptifibatide, dipyridamole, and abciximab.
Differences: Anticoagulants and Antiplatelets
While both anticoagulants and antiplatelets can reduce the risk of blood clot formation, they have different indications and contraindications. Anticoagulants are generally more effective at preventing clots in the veins, such as DVT and PE, while antiplatelets are more effective at preventing clots in the arteries, such as heart attacks and strokes. Anticoagulants are contraindicated in individuals with a history of bleeding disorders, recent surgery, or high risk of bleeding, while antiplatelets are contraindicated in individuals with a history of bleeding disorders or recent surgery.
In terms of side effects, both anticoagulants and antiplatelets can increase the risk of bleeding, which can range from minor bruising to life-threatening hemorrhage. Anticoagulants may also increase the risk of osteoporosis, while antiplatelets may increase the risk of gastrointestinal bleeding. In addition, anticoagulants may interact with other medications or foods, such as vitamin K-rich foods, which can affect their efficacy.
The following table highlights the major differences between Anticoagulants and Antiplatelets −
Characteristics |
Anticoagulants |
Antiplatelets |
|---|---|---|
Definition |
Anticoagulants are medications that interfere with clotting factors to stop the clotting process. |
Antiplatelets are medications that interfere and stop platelets from sticking together to form clots. |
What is targeted |
Anticoagulants target the specific clotting factors in the bloodstream. |
Antiplatelets target the platelets of the blood. |
Mode of action |
An anticoagulant may bind to antithrombin to stop thrombin from working, or interfere with vitamin K. |
An antiplatelet may bind to platelets affecting them, or increase cAMP which is involved in signaling of the clotting process. |
Uses |
Anticoagulant medicine is used for people who have had blood clots before or are at high risk. For instance, it is used for patients who have had a deep-vein thrombosis, or coronary artery thrombus. It is also given to patients who have atrial fibrillation since they have a high risk of clots. |
Antiplatelets are given to patients who have a history of ischemic strokes, or coronary artery blockages. The medicine is also used for people who have heart valve surgery, bypass surgery, or stents placed in their arteries. It is also good to use for people who are having a heart attack. |
Side effects |
The side effects of anticoagulants include high potassium levels, hemorrhage, and thrombocytopenia. |
The side effects of antiplatelets include hemorrhage, gastrointestinal upset, and dizziness. |
Conclusion
Anticoagulants are typically used to treat and prevent blood clots in the veins and arteries, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and stroke.
On the other hand, Antiplatelets are commonly used to prevent blood clots in individuals with cardiovascular disease, such as those with a history of heart attack, unstable angina, or peripheral artery disease.
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