Skip to main content

REVIEW article

Front. Pharmacol.
Sec. Cardiovascular and Smooth Muscle Pharmacology
Volume 15 - 2024 | doi: 10.3389/fphar.2024.1457280
This article is part of the Research Topic Cardiometabolic Diseases: Therapeutic Targets Discovery and Mechanism Study View all 10 articles

Anticoagulation Approach in Morbid Obesity: A Comprehensive Review on Venous Thromboembolism Management

Provisionally accepted
Victorita Sorodoc Victorita Sorodoc 1Andreea Asaftei Andreea Asaftei 2*Alexandr Ceasovschih Alexandr Ceasovschih 1*Catalina Lionte Catalina Lionte 1Simina Crisan Simina Crisan 3Mihai Constantin Mihai Constantin 1Lucia Indrei Lucia Indrei 1Laurentiu Sorodoc Laurentiu Sorodoc 1
  • 1 Grigore T. Popa University of Medicine and Pharmacy, Iași, Iasi, Romania
  • 2 Saint Spiridon Hospital, Iasi, Romania
  • 3 Victor Babes University of Medicine and Pharmacy, Timisoara, Timis, Romania

The final, formatted version of the article will be published soon.

    Obesity is a recognized risk factor for venous thromboembolism (VTE), associated with distinct challenges in managing anticoagulation therapy. There is still limited evidence regarding the impact of extreme body weight on the pharmacokinetics, pharmacodynamics, efficacy, and safety of various anticoagulant medications. To our knowledge, this is the first comprehensive review to address both prophylactic and therapeutic anticoagulant dosages specifically for managing VTE in patients with a body mass index (BMI) ≥40 kg/m² or weight ≥120 kg. Our aim was to synthesize the findings of relevant studies alongside the latest recommendations on anticoagulation in this unique population. We gathered and analyzed data on all classes of anticoagulants available for VTE management, including vitamin K antagonists (VKAs), unfractionated heparin (UFH), low-molecular-weight heparin (LMWH), fondaparinux, and direct oral anticoagulants (DOACs), offering insights into their efficacy and safety profiles. Additionally, we explored special subpopulations of morbidly obese patients, such as those with cancer, renal dysfunction, or those undergoing bariatric surgery, recognizing the nuanced therapeutic challenges they present. The current evidence for anticoagulant therapy in morbidly obese patients with VTE is evidently insufficient, underscoring the need for a tailored approach and meticulous monitoring to achieve an optimal therapeutic balance.

    Keywords: anticoagulation, morbid obesity, Venous Thromboembolism, Warfarin, Unfractionated heparin, low-molecular-weight heparin, Direct oral anticoagulant, bariatric

    Received: 30 Jun 2024; Accepted: 02 Dec 2024.

    Copyright: © 2024 Sorodoc, Asaftei, Ceasovschih, Lionte, Crisan, Constantin, Indrei and Sorodoc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Andreea Asaftei, Saint Spiridon Hospital, Iasi, 700111, Romania
    Alexandr Ceasovschih, Grigore T. Popa University of Medicine and Pharmacy, Iași, 700115, Iasi, Romania

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.