The coagulation system in atherothrombosis: Implications for new therapeutic strategies

Unlabelled Box Clinical manifestations of atherosclerotic disease include coronary artery disease (CAD), peripheral artery disease (PAD), and stroke. Although the role of platelets is well established, evidence is now accumulating on the contribution of coagulation proteins to the processes of ather...

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Bibliographic Details
Published in:Research and practice in thrombosis and haemostasis 2018-04, Vol.2 (2), p.188-198
Main Authors: Olie, Renske H., van der Meijden, Paola E.J., ten Cate, Hugo
Format: Article
Language:English
Subjects:
Anticoagulants
anticoagulation
antiplatelet therapy
Atherosclerosis
atherothrombosis
Blood clots
Blood platelets
Cardiovascular disease
coagulation
Collagen
Coronary vessels
Heart attacks
Hemophilia
Inflammation
Mortality
Proteins
Smooth muscle
State of the Art Isth 2017
Thromboembolism
Thrombosis
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Summary:Unlabelled Box Clinical manifestations of atherosclerotic disease include coronary artery disease (CAD), peripheral artery disease (PAD), and stroke. Although the role of platelets is well established, evidence is now accumulating on the contribution of coagulation proteins to the processes of atherosclerosis and atherothrombosis. Coagulation proteins not only play a role in fibrin formation and platelet activation, but also mediate various biological and pathophysiologic processes through activation of protease‐activated‐receptors (PARs). Thus far, secondary prevention in patients with CAD/PAD has been the domain of antiplatelet therapy, however, residual atherothrombotic risks remain substantial. Therefore, combining antiplatelet and anticoagulant therapy has gained more attention. Recently, net clinical benefit of combining aspirin with low‐dose rivaroxaban in patients with stable atherosclerotic disease has been demonstrated. In this review, based on the State of the Art lecture “Clotting factors and atherothrombosis” presented at the ISTH Congress 2017, we highlight the role of coagulation proteins in the pathophysiology of atherothrombosis, and specifically focus on therapeutic strategies to decrease atherothrombotic events by optimization of vascular protection.
ISSN:2475-0379
2475-0379
DOI:10.1002/rth2.12080