Antiplatelet and anticoagulant treatment – risk factors and mechanism of venous thrombosis

Abstract:

Venous thrombosis is a multifactorial and common disease, especially in the elderly. A number of risk factors for thrombosis have been identified, both acquired and / or hereditary. Frequent acquired risk factors are trauma, surgery, malignancy, immobilization, obesity and more. Hereditary risk factors are inherited antithrombin deficiency, a hereditary deficiency of protein C and S, FVLeiden mutation, prothrombin mutation and others. They alter the flow of blood, activate endothelium and the coagulation system. Risk factors for the development of recurrent thrombosis, which is particularly common, are also recognized. The mechanism which triggers a thrombus formation is still not entirely clear. The most common site for the thrombus formation is a deep vein sinus valve, where the blood circulation is slowed, leading to the blood stasis and hypoxia. Hypoxia and associated inflammation activate endothelium. Activated platelets bind on its surface initiating the coagulation process, with the thrombus as a final product. Novel targeted anticoagulants act on certain parts of a cascade of coagulation. It is therefore particularly important to know the sites of action of a particular drug. Detailed knowledge of molecular-level mechanism of thrombosis will enable the development of new targeted drugs.

Key words:
hemostasis; recurrent venous thromboembolism; factors of venous thromboembolism; venous thromboembolism