Review article: Coagulation cascade and therapeutics update: Relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants

Adams, Rebecca L. C. and Bird, Robert J. (2009) Review article: Coagulation cascade and therapeutics update: Relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants. Nephrology, 14 5: 462-470. doi:10.1111/j.1440-1797.2009.01128.x


Author Adams, Rebecca L. C.
Bird, Robert J.
Title Review article: Coagulation cascade and therapeutics update: Relevance to nephrology. Part 1: Overview of coagulation, thrombophilias and history of anticoagulants
Journal name Nephrology   Check publisher's open access policy
ISSN 1320-5358
1440-1797
Publication date 2009-08
Sub-type Article (original research)
DOI 10.1111/j.1440-1797.2009.01128.x
Volume 14
Issue 5
Start page 462
End page 470
Total pages 9
Place of publication Richmond, Vic., Australia
Publisher Wiley-Blackwell Asia
Collection year 2010
Language eng
Abstract Coagulation involves the regulated sequence of proteolytic activation of a series of zymogens to achieve appropriate and timely haemostasis in an injured vessel, in an environment that overwhelmingly favours an anticoagulant state. In the non-pathological state, the inciting event involves exposure of circulating factor VII/VIIa to extravascularly expressed tissue factor, which brings into motion the series of steps which results in amplification of the initial stimulus, culminating in the conversion of fibrinogen to fibrin and clot formation. The precisely synchronized cascade of events is counter-balanced by a system of anticoagulant mechanisms, which serve to ensure that the haemostatic effect is regulated and does not extend inappropriately. Conversely, in pathological states, these events can escape normal control mechanisms, due to either inherited or acquired defects, which lead to thrombosis. Current anticoagulant therapy, although based on medications that have been in existence for upwards of 80 years, is moving towards targeted therapy for specific coagulation factors and events in the coagulation cascade, based on the current knowledge of the main triggers and key events within the series of reactions that culminates in haemostasis. It remains to be seen whether these newer medications will become first-line therapies for thrombosis in the coming decade. This review aims to elucidate the main events within the coagulation cascade as it is currently understood to operate in vivo, with a brief discussion focusing on hypercoagulable states, and also a short review of the history of anticoagulants as they relate to this model.
Keyword Anticoagulant
Blood Coagulation
Haemostasis
Thromboplastin
Thrombosis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 37 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 13 Apr 2010, 16:15:13 EST by Fiona Mactaggart on behalf of Medicine - Princess Alexandra Hospital