Review Articles

To clot, or not to clot – Antithrombotic therapy is the question

E. Osuch, A. Marais
South African Family Practice | Vol 61, No 3 : May/June| a4966 | DOI: https://doi.org/10.4102/safp.v61i3.4966 | © 2019 E. Osuch, A. Marais | This work is licensed under CC Attribution 4.0
Submitted: 28 October 2019 | Published: 15 July 2019

About the author(s)

E. Osuch, Sefako Makghato Health Sciences University, South Africa
A. Marais, University of Pretoria, South Africa

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Abstract

Haemostasis and thrombosis rely on three components namely the vascular endothelial wall, blood platelets and the coagulation cascade. Non-physiologic excessive thrombosis occurs when haemostatic processes are dysfunctional, causing undue clot formation or reduced clot lysis. Antithrombotic agents including antiplatelet, anticoagulation and fibrinolytic agents are essential for the prophylaxis and pharmacological management of venous thromboembolism and arterial thrombosis. Anticoagulation treatment options have expanded steadily over the past few decades, providing a greater number of agents. Anticoagulants that directly target the enzymatic activity of thrombin and factor Xa have recently been developed to address the inadequacies of traditional vitamin K antagonists. Appropriate use of these agents requires knowledge of their individual characteristics, risks, and benefits.

Keywords

anticoagulant; antiplatelet; direct oral anticoagulants (DOACs); haemostasis; thromboembolism; thrombolytic therapy; vitamin K antagonists

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