PMID: 16529549Mar 15, 2006Paper

Pathophysiological basis for anticoagulant and antithrombotic therapy in pulmonary hypertension

Cardiovascular & Hematological Agents in Medicinal Chemistry
Antonio A Lopes

Abstract

In pulmonary hypertension (PH), thrombosis and thromboembolism may occur as primary events associated with inherited or acquired thrombophilia. Alternatively, in situ thrombosis may develop as a complication of pre-existing vasculopathy as in the case of idiopathic PH and related disorders (so called pulmonary arterial hypertension). In these disorders, a number of abnormalities has been described involving endothelial cells, platelets and other circulating cellular and soluble elements. These abnormalities are suggestive of a shift of pulmonary vascular microenvironment toward a procoagulant, prothrombotic and antifibrinolytic pattern. The abnormalities described so far include circulating antiphospholipid antibodies, increased plasma levels of platelet aggregating agents (serotonin, thromboxane), adhesion molecules (P-selectin, von Willebrand factor), antifibrinolytic enzymes (plasminogen activator inhibitor 1) and cytokines. Also, decreased endothelial production of natural anticoagulants (thrombomodulin) and platelet antiaggregating substances (nitric oxide, prostacyclin) have been demonstrated. The present review is focused on the procoagulant, prothrombotic and antifibrinolytic mechanisms so far identified in PH, in both ...Continue Reading

Citations

Nov 7, 2012·Pulmonary Circulation·Michael H Kroll, Vahid Afshar-Kharghan
May 19, 2011·Journal of Thrombosis and Haemostasis : JTH·C CavestroD Roccatello

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