The coagulation system in atherothrombosis: Implications for new therapeutic strategies

Area of Science:

• Cardiovascular Medicine
• Hematology
• Thrombosis Research

Background:

• Atherosclerotic disease, including coronary artery disease (CAD), peripheral artery disease (PAD), and stroke, has significant clinical manifestations.
• While platelets are known contributors, coagulation proteins are increasingly recognized for their role in atherosclerosis and atherothrombosis.
• Coagulation proteins influence fibrin formation, platelet activation, and mediate pathophysiologic processes via protease-activated receptors (PARs).

Purpose of the Study:

• To review the role of coagulation proteins in atherothrombosis pathophysiology.
• To explore therapeutic strategies for decreasing atherothrombotic events.
• To highlight the potential of optimizing vascular protection in patients with atherosclerotic disease.

Main Methods:

• Review of current literature and state-of-the-art lecture findings.
• Focus on the biological and pathophysiologic roles of coagulation proteins.
• Analysis of therapeutic strategies combining antiplatelet and anticoagulant therapies.

Main Results:

• Coagulation proteins are integral to atherothrombosis beyond fibrin formation.
• Residual atherothrombotic risk remains substantial with antiplatelet therapy alone.
• Combining aspirin with low-dose rivaroxaban shows net clinical benefit in stable atherosclerotic disease.

Conclusions:

• Coagulation proteins are critical targets for managing atherothrombosis.
• Combined antiplatelet and anticoagulant therapy offers a promising approach to reduce residual risk.
• Optimizing vascular protection through novel therapeutic strategies is essential for improved patient outcomes.