New Anticoagulants — The Path from Discovery to Clinical Practice

For more than half a century, heparin and vitamin K antagonists have defined anticoagulant therapy for the short-term and long-term management, respectively, of thrombotic disorders of the venous system. The history of their development is instructive. In 1922, at the annual meeting of the American Physiological Society, William H. Howell of Johns Hopkins Medical School presented an extraction protocol for isolating heparin preparations. Dicoumarol, a bacterial antagonist of vitamin K in spoiled sweet clover, was recognized as the agent responsible for a fatal hemorrhagic disease in livestock by Karl Link and Wilhelm Schoeffel of the University of Wisconsin. In both . . .