Treatment with rivaroxaban and ASA, after success­ful endovascular recanalization, in a subject with multi complicated peripheral arterial disease. Case report

Preserving the clinical result of revascularization in diabetic patients, usually affected by a complex and often progressive form of arteriop­athy, is a mandatory challenge to reduce major amputations rate and the related mortality rate as well. Low doses of the new NOAC anticoag­ulant drugs, more manageable than traditional coumarin drugs, if asso­ciated with ASA and / or clopidogrel, have shown a significant efficacy in thrombosis prevention, in subjects who underwent endovascular or surgical revascularization. Contraindications end cautions are neces­sary in subjects with ESRD, dialysis, mechanical prosthetic heart valves and old in age. KEY WORDS peripheral arterial disease; diabetes; thrombosis; anticoag­ulants.

Antagonists of Vitamin K—Popular Coumarin Drugs and New Synthetic and Natural Coumarin Derivatives

Many natural coumarins and their chemically synthesized analogs and derivatives exert diverse properties, such as anticancer, antioxidant, anti-inflammatory, or anticoagulant, with the latter being of the utmost importance. The widely used warfarin, acenocoumarol, and phenprocoumon exert anticoagulant properties by inhibiting the vitamin K epoxide reductase complex. In this interdisciplinary review, we present biochemical principles of the coagulation processes and possible methods for their tuning based on the use of coumarins. We also summarize chemical methods of synthesis of coumarins and discuss structures and properties of those that have been used for a long time, as well as newly synthesized compounds. Brief information on the clinical use of coumarins and other anticoagulant drugs is given, including the severe effects of overdosing and methods for reversing their action.