Moving Up the Coagulation Cascade: Potential Factor X Inhibition for Percutaneous Coronary Intervention

Contrary to recent thinking in platelet biology, which had taken a strong stance on final common pathway concepts, the pharmacologic approach to tempering vascular coagulation has moved upstream to earlier steps in the fundamental process. Because coagulation represents a series of bioamplification sequences, the inhibition of early autocatalytic reactions minimizes the production of downstream substrate. The neutralization of factor X, a pivotal coagulation protease in thrombin generation, represents a particularly attractive target in arterial thrombosis following vessel wall trauma in percutaneous coronary interventions.