Warfarin- mediated hemostasis is achieved by the balance of inhibition of procoagulant factors VII, IX, X, and II, and anticoagulant factors C. The half-Life of anticoagulant factors C is shorter (about 6 hrs) compared to 24, 40, and 60 hours for factors IX, X, and II respectively. Thus the immediate effect of warfarin is to deplete the anticoagulant protein C, which can paradoxically create a transient hypercoagulable state.
For this reason heparin is initially used (FOR 5-7 DAYS) in patients with active DVT or Pulmonary Embolism to achieve immediate anticoagulation until adequate warfarin-induced depletion of the procoagulant . . .
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