Pathophysiology and therapeutic modification of thrombin generation in patients with coronary artery disease
Review published in European Journal of Pharmacology (2000)
Abstract
Thrombin plays a central role in thrombogenesis: it activates platelets, converts fibrinogen to fibrin, and activates factor XIII, which then crosslinks and stabilizes the fibrin clot. In addition, thrombin amplifies coagulation by activating factors VIII and V, key cofactors in the generation of activated factor X and thrombin, respectively. Even platelet function is influenced by thrombin. Hence, thrombin generation is most important both in the chronic progression of coronary atherosclerotic disease and in its conversion to acute events. To date, various therapeutic approaches capitalize on this knowledge by targeting specific thrombin-related pathways. Among the successful and carefully documented pharmacologic strategies in acute or chronic coronary heart disease are the use of unfractioned heparin, low-molecular-weight heparin, thrombolysis, hirudin, and/or inhibition of thrombin generation by glycoprotein IIb/IIIa antagonists, most often utilized on top of antiplatelet therapy (e.g., with acetylsalicylic acid) and/or vitamin K antagonism. The present review provides insights into the pathophysiology of thrombin generation in coronary atherosclerosis and gives an overview over the above mentioned therapeutic thrombin modifications.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Review of thrombin's central role in coronary artery thrombosis and therapeutic strategies including unfractionated heparin, LMWH, thrombolysis, hirudin, and GPIIb/IIIa antagonists.
Por qué esto importa para la hirudoterapia
Esta revisión examina el papel central de la trombina en la fisiopatología de la enfermedad coronaria —activación plaquetaria, conversión de fibrinógeno en fibrina y amplificación de la coagulación— y analiza los enfoques terapéuticos dirigidos a las vías relacionadas con la trombina. La hirudina se menciona entre varias estrategias farmacológicas exitosas junto con la heparina, la heparina de bajo peso molecular, la trombólisis y los antagonistas de la glucoproteína IIb/IIIa. El artículo tiene relevancia indirecta para la hirudoterapia, ya que la hirudina se comenta como una de las varias estrategias antitrombóticas en la enfermedad coronaria. No obstante, se trata de una revisión narrativa, la hirudina es solo uno de los muchos agentes comentados sin una profundidad específica sobre los terapéuticos derivados de la sanguijuela, y no se presentan nuevos datos primarios.
Citación
Pathophysiology and therapeutic modification of thrombin generation in patients with coronary artery disease.
Pothula A et al. · European Journal of Pharmacology, 2000
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026