# Preclinical Evaluation of the Anticoagulant Effect of an Aqueous Extract of Snow Mountain Garlic
## 1 Introduction  
Thrombosis is the most common cause of death among people suffering from cardiovascular disease. It manifests through vascular occlusion, leading to severe conditions such as myocardial infarctions, cerebrovascular accidents, and venous thromboembolism. This issue presents a global public health problem, causing the deaths of 1-5 people per 1000 [1]. The discovery of agents that lengthen coagulation times began in 1916; in 1918, [PERSON] demonstrated the anticoagulant action of extracts of dog liver, called heparin [2, 3]. It was 23 years later that [PERSON] and colleagues isolated and characterized the hemorrhagic agent 3,3'-methylenebis-(4-hydroxycumarin), known as dicumrol or hydroxycumarin, which served as a basis for developing synthetic anticoagulants. Clinical use of warfarin for humans was approved in 1954 [4]. The search for new anticoagulants to overcome the limitations of vitamin K antagonists (VKAs) has been promoted; they must have several characteristics, such as being administered orally, demonstrating a low risk of bleeding, not requiring constant medical monitoring of coagulation, not needing to adjust the dose, and having a low level of interaction with drugs and food, that reduce the effects of blood-material contact (for example, cannula of the extracorporeal life support) and improve their hemocompatibility [5; 6; 7]. The development of oral anticoagulants to replace AVK has been slow. Dabigaran, an oral thrombin inhibitor, rivaroxaban, and apixaban, which are oral factor Xa (FXa) inhibitors, are currently available [8]; however, bleeding rates from their use are similar to those of warfarin, depending on the pathologies that cause clot formation. Regardless, comparative efficacy data applied in the clinic are limited [9]; they also present several serious inconveniences depending on the medical or surgical problem that a patient is facing, as well as being susceptible to drug interactions [10]. This leads to the search for natural active ingredients that, at a certain point, offer greater safety in their use. One such option is plant- or food-derived substances. Thus, traditional medicine is used worldwide because it is accessible and culturally accepted [11]. For millions of people, it is the main and/or only source of healthcare. The World Health Organization (WHO) recognizes that traditional medicine must be incorporated into the health systems of each country [12]. One of the most studied species is _Allium_. For example, some aqueous extracts, ethanolic, methanolic, powders, and oils of _A. sativum_ L. have been studied which show anticoagulant activity _in vitro_, _in vivo_, and in humans. The chemical compounds which this property has been attributed to are allicin, trisulphide diallyl, disulfid diallyl, and ajoenes. These sulfurous compounds, according to different authors, have a platelet agonist effect [13; 14; 15], fibrinolytic activity with a delay of up to 12 h [16] in coagulation time [17; 18], prothrombin delay [19; 20], platelet thromboxane formation 5 [15], improve plasmin generation via t-PA, antithrombin activity III [20; 21], inhibit protein C [20], and decrease the coagulation factors V, VII, and VIII; certain levels of protein C, IX, and X [22] have led to the inhibition of 5-lipoxygenase and cyclooxygenase through a decrease in thrombocytic aggregation [23]. Similarly, studies of onion (_Allium cepa_) have documented that sulfur compounds and some phenolic compounds also act as antiplatelet agents [24]. However, findings are not yet conclusive, and they depend on the sample size of the studied population, the dose of the sulfur compounds, their mode of action, and how they are consumed to achieve anticoagulant activity. Although there are many studies on the anticoagulant effect on plants of the genus _Allium_, little is known about _Allium ampleprorasum_ L. (Snow mountain garlic); recently, it has been shown to have a fungicidal effect on candida species as well as antiarthritic, anti-inflammatory, and analgesic effects [25; 26; 27].