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Venous and arterial thrombosis – pathogenesis and the rationale for anticoagulation

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: http://dx.doi.org/10.1160/TH10-10-0683
Issue: 2011: 105/4 (Apr) pp. 571-741
Pages: 586-596

Venous and arterial thrombosis – pathogenesis and the rationale for anticoagulation

A. G. G. Turpie (1), C. Esmon (2)

(1) Department of Medicine, McMaster University, Hamilton, Ontario, Canada; (2) Oklahoma Medical Research Foundation, Howard Hughes Medical Institute, and Departments of Pathology and Biochemistry & Molecular Biology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA

Keywords

Venous thrombosis, anticoagulation, factor Xa, thrombin, Arterial thrombosis

Summary

Thromboembolic disorders are major causes of morbidity and mortality. It is well-recognised that the pathogenesis is different for arterial and venous thrombosis; however, both involve coagulation activation. Anticoagulants are used for the prevention and treatment of a wide variety of thromboembolic and related conditions. Agents with anti- inflammatory properties in addition to anticoagulation may be particularly beneficial. Traditional anticoagulants, although effective, are associated with certain limitations. Understanding the pathological processes associated with thrombosis and the rational target for anticoagulation is essential, not only for the development of safer and more effective agents, but also for better clinical management of patients who require anticoagulation therapy. In recent years, new oral agents that target single enzymes of the coagulation cascade have been developed – some of those are in advanced stages of clinical development. Based on scientific rationale, both factor Xa and thrombin are viable targets for effective anticoagulation.

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