Anticoagulants beyond coagulation: a narrative review of cardiovascular effects

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Authors: Annisa Aarts, Hugo ten Cate, Arina ten Cate
Cited by: 3
References: 174

Abstract

Anticoagulants are widely used to prevent and treat thrombotic disorders, and continuous advances have refined their efficacy and safety. Beyond their established anticoagulant function, growing evidence indicates that some agents exert additional cardiovascular effects through pleiotropic mechanisms. In this narrative review, we examine both the intended and potential unintended effects of anticoagulants, with particular attention to their actions beyond coagulation. We discuss their influence on vascular pathology and cardiac function, highlighting distinctions between different anticoagulant classes. A deeper understanding of these pleiotropic effects may help guide future research, improve long-term outcomes, and support more targeted therapeutic strategies for patients most likely to benefit.

Fields of Study & Subjects

Atrial Fibrillation Management and Outcomes Blood Coagulation and Thrombosis Mechanisms Antiplatelet Therapy and Cardiovascular Diseases

Publication details

Journal / source
Cardiovascular Research
Publisher
Oxford University Press (OUP)
Volume
122
Issue
5
Pages
562–577
Publication date
20 February 2026
Language
EN