title: The spectrum of thrombin in acute coronary syndromes.
abstract: The role of thrombin in vascular physiology and pathophysiology continues to impact our understanding of many cellular processes and systems including the function of platelets, endothelial cells, smooth muscle cells, leukocytes and the regulation of the coagulation cascade. Recent acute coronary syndrome clinical trial results that have compared the use of parenteral or oral anticoagulants versus or in combination with anti-platelet agents have forced a reexamination of the importance of thrombin activity in influencing patient outcomes, particularly in the area of secondary prevention. The debate of the need to include oral anticoagulation as a concomitant or replacement therapy to an antiplatelet regimen as a means to improve patient outcomes requires further examination and larger prospective clinical trials.
authors.affiliation: Department of Internal Medicine, The University of Tennessee Health Science Center, 956 Court Avenue, Coleman H300, Memphis, TN 38163, USA.
authors.forename: Smith
authors.initials: S
authors.lastname: Giri
authors.affiliation: Department of Internal Medicine, The University of Tennessee Health Science Center, 956 Court Avenue, Coleman H300, Memphis, TN 38163, USA; Vascular Biology, The University of Tennessee Health Science Center, 956 Court Avenue, Coleman H300, Memphis, TN 38163, USA; Department of Microbiology, Immunology and Biochemistry, The University of Tennessee Health Science Center, 956 Court Avenue, Coleman H300, Memphis, TN 38163, USA. Electronic address: ljennings@uthsc.edu.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Jennings
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000378:metabolism; D000284:Administration, Oral; D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use; D050197:Atherosclerosis; D001777:Blood Coagulation; D001792:Blood Platelets / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002986:Clinical Trials as Topic; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation; D051379:Mice; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D044463:Receptor, PAR-1 / Q000378:metabolism; D018179:Receptors, Thrombin / Q000378:metabolism; D012307:Risk Factors; D055502:Secondary Prevention; D013917:Thrombin / Q000737:chemistry / Q000502:physiology*; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D044463:Receptor, PAR-1; D018179:Receptors, Thrombin; C105295:protease-activated receptor 3; D014859:Warfarin; D013917:Thrombin
keywords: Acute coronary syndromes; Anti-platelet therapy; Anticoagulants; Coagulation; Endothelial cells; Platelets; Thrombin