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Difference Between Procoagulant and Anticoagulant

Coagulation, also called clotting, is the process by which blood changes to a solid or semi-solid state. Procoagulants are natural substances, or factors, most often proteins in the blood, which when activated, promote or make the coagulation of the blood possible (Miller-Keane Encyclopedia). Anticoagulants are pharmaceuticals, such as heparin or warfarin (MedlinePlus), that are used to slow down the process of clotting and thus prevent blood clots from forming or increasing in size. Anticoagulants, unlike procoagulants, therefore support the flow of blood rather than support clotting of the blood.

The Nature of Procoagulants

Procoagulants promote clotting to stem blood flow. Twelve factors manufactured by the liver, four steps, and three components support this process. The factors are named in the order they were discovered, and there are thirteen numerals but only 12 factors because Factor 6 was found to be part of another factor (Blood Coagulation Process). Factor 1 is also called fibrinogen. Factor 2, also called prothrombin, is a protein in the blood. Factor 3 is a tissue factors called tissue thromboplastin. Factor 4 is also called ionized calcium, which is a chemokine released in large quantities in the vicinity of growing blood clots, and results in a translucent jelly-like clot. Factor 5 is a labile factor also called proaccelerin. Factor 6 is stable factor that is also known as proconvertin. Factor 8 is an antihemophilic factor. Factor 9 is called the Christmas factor, Factor 10 Stuart-Prower, Factor 11 plasma thrombin, Factor 12 the Hageman, and Factor 13 is a fibrin stabilizing factor. 

The four steps involve constriction of the blood vessel, platelet plug formation, activation of a coagulation cascade, and finally, the formation of a fibrin plug (Andrew LaPelusa and Dave). Normal hemostasis requires the following components: blood cells (platelets), cells that line the blood vessels (endothelial cells) and blood proteins. Blood clotting proteins, or procoagulants, when activated, generate thrombin (Factor 11), an enzyme that converts fibrinogen (Factor 1) to fibrin, and the formation of a fibrin clot (Britannica). 

The Nature of Anticoagulants

Anticoagulants are pharmaceutical products that interrupt the process of blood clot formation. They are sometimes called “blood-thinning” medicines, although they serve to interrupt the clotting process rather than make the blood thinner. Anticoagulants such as heparin or warfarin, for example, slow down the body’s process of making clots (Medline Plus). Anticoagulant products are used if a person is at risk of developing blood clots that could potentially block a blood vessel and disrupt the flow of blood around the body. A deficiency in Factor 7 (proconvertin) in the blood, for example, leads to blood clotting. 

Caution must be exercised when using anticoagulants because some interact with certain foods, medicines, vitamins, and alcohol. According to Medline Plus, bleeding is the most common side effect of anticoagulant products, but they can also affect the digestive system

Treatment of Blood Coagulation Abnormalities

Disorders of coagulation are disease states that cause hemorrhage, or the escape of blood from ruptured veins or arteries (Britannica), or cause clots in veins and arteries that prevent blood from flowing, for example, thrombosis (John Hopkins Medicine).

Procoagulant abnormalities cause bleeding because the blood fails to clot. Most bleeding disorders are rare and inherited (Medline Plus). The most well-known bleeding disorder is hemophilia. Hemophilia is caused when coagulation Factors 8 or 9 are missing (hemophilia A) or defective (hemophilia B). More people in America are affected by von Willebrand disease, an inherited bleeding disorder caused by the lack of clotting factors or proteins (American Society of Hematology). 

Anticoagulant abnormalities cause blockages because the blood clots too easily and are the leading cause of death world-wide, with treatment costing an estimated $250 billion and projected to triple to $818.1billion by 2030 (P. A. Heidenreich et al.). Increased levels of plasma procoagulant proteins such as prothrombin (Factor 2) and fibrinogen (Factor 1) are established risk factors for thrombosis, or blockages of the blood vessels. 

Treatment for blood clotting diseases, for example, warfarin, acts on the liver to decrease the quantity of clotting factors in the blood. Treatment demands a precarious balancing act, however. For example, when the hemostatic agent recombinant factor 7 is activated, it is highly effective at minimizing bleeding in hemophilic patients. However, its off-label use in patients who are not hemophilic can cause thrombosis. So, while recently approved antithrombotic dabigatran exhibits have shown improved safety and efficacy as compared to warfarin, no rapid reversal agent is currently available, which may leave patients prone to bleeds when taking such medication (Alisa S. Wolberg et al.) 

Table of the summary of differences between procoagulants and anticoagulants


Procoagulants are natural substances, most often proteins in the blood, which when activated, promote or make the coagulation of the blood possible. Anticoagulants are pharmaceutical products, such as heparin or warfarin, and are used to slow down the process of clotting and thus prevent blood clots from forming or increasing in size. Procoagulant abnormalities are rare and most often inherited whereas anticoagulant abnormalities are a leading cause of death worldwide. 


What is the function of procoagulant?

A procoagulant is a natural substance in the blood, most often a protein, that enables the blood to clot and thereby stems bleeding. 

Are clotting factors procoagulant?

A variety of procoagulant factors in the blood assist clotting, whereas anticoagulant substances assist the blood to flow. Clotting factors are therefore procoagulants when activated. 

Which is a procoagulant drug?

Procoagulant drugs such as desmopressin, antifibrinolytics, and vitamin K are agents used to prevent blood flow and encourage clotting (Rainer B. Zotz et al.).  

Is Heparin a procoagulant?

Heparin is generally understood to have an anticoagulant effect rather than procoagulant effect because it inactivates coagulation enzymes and inhibits thrombin, thus preventing fibrin formation or clots (Jack Hirsh et al.). 

What is procoagulant give example?

Vitamin K is one of the few easily accessible procoagulants or substances that supports the ability of the blood to coagulate or clot and stem bleeding.

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References :

[0]American Society of Hematology. Bleeding Disorders. 2022. https://www.hematology.org/education/patients/bleeding-disorders#:~:text=Hemophilia%20is%20perhaps%20the%20most,America%20caused%20by%20clotting%20proteins.

[1]P. A. Heidenreich et al. “Forecasting the Future of Cardiovascular Disease in the United States: A Policy Statement from the American Heart Association. Circulation, vol 123, 2011, pp. 33–44. https//doi.org/10.1161/CIR.0b013e31820a55f5

[2]Jack Hirsh et al. “Guide to Anticoagulant Therapy: Heparin.” American Heart Association, vol. 103, no. 24, 2001, pp. 2994‒3018,https://doi.org/10.1161/01.CIR.103.24.2994Circulation.

[3]John Hopkins Medicine. Thrombosis. 2022. https://www.hopkinsmedicine.org/health/conditions-and-diseases/thrombosis

[4]Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. “Procoagulant,” 2003. https://medical-dictionary.thefreedictionary.com/procoagulant

[5]Alisa S. Wolberg, et al. “Procoagulant Activity in Hemostasis and Thrombosis: Virchow’s Triad Revisited.” Anesthesia & Analgesia, vol. 114, no. 2, Feb 2012, pp. 275–285. https//doi.org/10.1213/ANE.0b013e31823a088c

[6]R. B. Zotz et al. “Procoagulant Drugs.” In: C. Marcucci and P. Schoettker (eds), Perioperative Hemostasis. Springer. https://doi.org/10.1007/978-3-642-55004-1_12

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