Download PDF
Phlebologie 2014; 43(02): 93-98
DOI: 10.12687/phleb2179-2-2014
Medical history
Schattauer GmbH

Curious stories surrounding the discovery and development of conventional antithrombotics

Article in several languages: English | deutsch
M. Haug
Further Information

Publication History

Received: 11 November 2013

Accepted: 09 January 2014

Publication Date:
04 January 2018 (online)

Also available at
    Permissions and Reprints

Summary

In former times, the discovery of a therapeutic effect was usually a chance event. The route to clinical use was frequently long and arduous and often associated with curious stories, as is the case with the antithrombotic agents, heparin, aspirin and warfarin.

Heparin: Who deserves the credit for discovering the substance? The student, Jay McLean, who, in addition to finding the thromboplastic cephalin components he was searching for, also chanced upon an anticoagulant component? Or his supervisor, who later took up McLean’s “chance discovery” and also isolated anticoagulant components that were chemically distinct from McLean’s but became the precursor substance of today’s heparin?

Aspirin: Long known as an analgesic and antipyretic drug, it has enjoyed a second career in cardiovascular medicine. It was not until 1967 that aspirin’s antiplatelet activity was recognised. Its second career began with the marketing authorisation for transient ischaemic attack (TIA) and myocardial infarction at the beginning of 1980. Until that time, the story of Dr Craven had remained unknown. In 1950, he had published his observations in “obscure” journals, stating that none of his patients who were taking aspirin had suffered a myocardial infarction.

Warfarin: Around 1920, thousands of North American cattle were dying of internal haemorrhage. The deaths were found to be due to the ingestion of stored “sweet clover”. It took years to discover the explanation: transformation of the non-toxic coumarin in the hay to the anticoagulant dicoumarol through fungal infection. Synthesis soon followed, with clinical use as an antithrombotic drug, although the substance enjoyed much greater success as the rat poison warfarin. It was not used again in humans until a soldier survived his suicide attempt thanks to vitamin K administration.

Keywords

Anticoagulation - vascular surgery - drug therapy - history of discovery