From the 1940s to 1990s, heparin and warfarin have been the main anticoagulants for the
prevention and treatment of thrombotic events. Since then, LMWHs and fondaparinux
proved effective in clinical trials, with better pharmacokinetic profiles and no monitoring
requirements. Developed in the early 21st century, DOACs have comparable efficacy to
LMWHs, but increase bleeding risk, as the anticoagulant targets (FIIa, FXa) are also
essential for physiological hemostasis. In contrast, selective inhibition of the intrinsic …