ABSTRACT
Arterial and venous thromboses are major causes of morbidity and mortality. Whereas arterial thrombosis is the most common cause of myocardial infarction (MI), stroke, and limb gangrene, venous thrombosis can be complicated by potentially fatal pulmonary embolism (PE) and post-phlebitic syndrome. Arterial thrombi, which form under highshear conditions, consist of platelet aggregates held together by small amounts of fibrin. Because of the preponderance of platelets, strategies to inhibit arterial thrombogenesis focus mainly on drugs that block platelet function. However, such strategies often include anticoagulants to prevent fibrin deposition, and these are also the drugs of choice for prevention of cardioembolic events. In contrast to arterial thrombi, venous thrombi are predominantly composed of fibrin and trapped red blood cells and contain relatively few platelets. Consequently, anticoagulants are the mainstay for prevention and treatment of venous thrombosis. Focusing on new anticoagulant drugs for the prevention and treatment of arterial and venous thrombosis, this chapter (i) reviews arterial and venous thrombogenesis, (ii) outlines new anticoagulant strategies, and (iii) provides clinical perspective as to which new strategies have the greatest chance of success.
