Antithrombotic therapy in acute coronary syndrome: how far up the coagulation cascade will we go?
The contribution of thrombosis to the natural history and clinical expression of advanced atherosclerotic coronary artery disease is well established. Less well understood is the biochemical and pathobiological distinction between normal hemostasis and thrombosis as the proximate cause of acute coronary syndrome. In this article, we summarize an evolving area of interest within the field of antithrombotic therapy--the contact system and the intrinsic pathway of coagulation, focusing our discussion on factors XI, XII, and IX to include their biochemical properties, relationship to arterial thrombosis phenotypes, and rational for future investigation of targeted pharmacotherapy.
Woodruff
Becky
B
Cardiovascular Thrombosis Research Center, Duke Clinical Research Institute, Duke Translational Research Institute, 2400 Pratt Street, Room 0311 Terrace Level, Durham, NC 27715, USA.
Sullenger
Bruce
B
Becker
Richard C
RC
D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D001777:Blood Coagulation; D003324:Coronary Artery Disease; D005164:Factor IX; D005172:Factor XI; D005174:Factor XII; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D010641:Phenotype; D013927:Thrombosis
D005343:Fibrinolytic Agents; D005164:Factor IX; D005174:Factor XII; D005172:Factor XI