Thrombotic risk factors: Basic pathophysiology

  title={Thrombotic risk factors: Basic pathophysiology},
  author={Ida Martinelli and Paolo Bucciarelli and Pier Mannuccio Mannucci},
  journal={Critical Care Medicine},
Although venous thrombosis has been traditionally associated with stasis and hypercoagulability, arterial thrombosis is mainly associated with heightened platelet reactivity and damage to the vessel wall. Accordingly, classic risk factors for venous and arterial thrombosis are usually considered distinct. Those for the former include cancer, surgery, pregnancy, and estrogens use, whereas risk factors of arterial thrombosis include smoking, hypertension, diabetes, the metabolic syndrome, and… 

Clotting problems: diagnosis and management of underlying coagulopathies.

The aim of this review is to provide a practical overview with guidelines for detecting, and treatment of, the principal underlying coagulopathies that a vascular surgeon should be aware of in his/her practice and for the care of patients with vascular disease.

The real value of thrombophilia markers in identifying patients at high risk of venous thromboembolism

The current knowledge on the various thrombophilia markers is summarized, and their role in the development of thromboembolic complications is discussed.

Autoimmune diseases and venous thromboembolism: a review of the literature.

Epidemiological, clinical, and experimental evidence for the connection between VTE and autoimmune and immune-mediated disorders is described and indicates that autoimmune disorders should not only be viewed as inflammatory disorders, but also hypercoagulable disorders.

Uncertain thrombophilia markers.

A number of additional abnormalities have been less consistently associated with an increased VTE risk, and there is insufficient ground to recommend their inclusion within the framework of conventional thrombophilia testing.

Etiology and Assessment of Hypercoagulability with Lessons from Heparin-Induced Thrombocytopenia

The etiology, risks, and assessment ofThrombophilia is reviewed, with emphasis on the clinical lessons learned from heparin-induced thrombocytopenia, which has been well studied and responds to appropriate therapy.

Classic thrombophilic gene variants.

Non-O blood group has been consistently demonstrated to be the most frequent inherited marker of an increased risk of VTE and the mechanism role of these inherited thrombophilia markers will be discussed in this narrative review.

Venous Thromboembolism in Patients With Thrombocytopenia: Risk Factors, Treatment, and Outcome

Patients having thrombocytopenia with VTE seem to be safely treated with anticoagulants without increased occurrence of bleeding, and several known VTE risk factors also seems to apply in patients with thromBocy Topenia.

Thrombophilia Screening: Universal, Selected, or Neither?

  • G. ColucciD. Tsakiris
  • Medicine
    Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
  • 2017
A comprehensive workup including personal and familial history, clinical examination, and laboratory test results including hereditary thrombophilia remains helpful in assessing the cumulative risk and the management of this group of selected patients.

Simultaneous intracoronary, intracardiac, and pulmonary venous thrombosis.




Venous and arterial thrombosis: different sides of the same coin?

The metabolic syndrome and the risk of arterial and venous thrombosis.

Aging and thrombosis.

Advanced age is associated with elevated interleukin-6 (IL-6) and C-reactive protein levels, indicating an inflammatory state that may be an important stimulus for thrombus formation in the elderly.

Hyperhomocysteinemia, atherosclerosis and thrombosis.

Additional studies are needed to define whether hyperhomocysteinemia is a risk factor for thrombosis, especially of the venous circulation, and randomized, placebo-controlled, double-blind trials of the effects of homocysteine-lowering vitamins on the thromBotic risk are urgently needed.

Hemostatic and inflammatory markers as risk factors for coronary disease in the elderly.

  • R. Tracy
  • Medicine
    The American journal of geriatric cardiology
  • 2002
Hemostatic markers that represent inflammatory processes or coagulation activation also predict future risk in older individuals, but there is little evidence for associations between cardiovascular disease risk and ambient levels of coagulations or fibrinolytic factors.

Age-related changes in the hemostatic system

Clinical and experimental evidence suggests that endothelium could play a central role in hemostatic alterations which determine a thrombophilic state in the elderly.

Diabetes mellitus as a prothrombotic condition

  • P. Grant
  • Medicine, Biology
    Journal of internal medicine
  • 2007
The combination of increased circulating coagulation zymogens, inhibition of fibrinolysis, changes in fibrin structure/function and alterations in platelet reactivity creates a thrombotic risk clustering which underpins the development of cardiovascular disease.

Genetic susceptibility to venous thrombosis.

Conditions involving a genetic predisposition to venous thrombosis, one of the leading causes of mortality and morbidity, increases from 1 per 100,000 during childhood to 1 every 100 in old age, is discussed.

Occlusive vascular diseases in oral contraceptive users. Epidemiology, pathology and mechanisms.

Information from published studies of the epidemiology and pathology of the occlusive vascular diseases and their risk factors are integrated to identify likely explanations for pathogenesis in oral contraceptive users and to understand vascular occlusion in Oral contraceptive users.

Inflammation and thrombosis

  • C. Esmon
  • Biology, Medicine
    Journal of thrombosis and haemostasis : JTH
  • 2003
A review of the interactions between inflammation and coagulation and inflammatory mediators will summarize the insights into the evolution and linkages that have become evident from recent structural studies.