Vitamin K antagonists such as warfarin and acenocumarol are the most
widely used oral anticoagulants. Their clinical indications include both stroke
prevention and prophylaxis and treatment of venous thromboembolism. Intracerebral
hemorrhage (ICH) is the most important side effect of anticoagulant therapy accounting
for almost 20% of all ICH. Non vitamin K anticoagulants or direct oral anticoagulants
(DOACs) have been recently introduced in clinical practice due to their practical
advantages over VKA. They are at least as effective as warfarin in the management of
thromboembolic diseases and in the thromboprophylaxis of non-valvular atrial
fibrillation, moreover, they have a more favorable safety profile. The present chapter
will focus on vitamin K antagonists and DOACs mechanisms of action, on their
pharmacokinetics and pharmacodynamics, and on the relative risk of bleeding during
treatment.
Keywords: Anticoagulation reversal, Anticoagulants, Bleeding risk, Intracerebral
hemorrhage.
