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  • Steering Committee Films Introduction

    Steering Committee Films Introduction

    Sylvia Haas, Graham Turpie, Greg Lip and Ajay Kakkar give an overview of the website.

  • The need for prevention

    The need for prevention

    Thrombosis, the formation of a blood clot within the circulatory system, is a leading cause of death and disability. The risk of thrombosis after major surgery is high, and approximately one out of every two patients undergoing major orthopaedic surgery without thromboprophylaxis will develop deep vein thrombosis (DVT). Other illnesses are also associated with a high risk of thrombosis, and up to 15% of patients hospitalized for an acute medical illness develop venous thromboembolic disease. In Europe, it is estimated that there are more deaths each year as a result of venous thromboembolism (VTE) than caused by breast cancer, prostate cancer, AIDS and transport accidents combined.

The coagulation cascade

The coagulation cascade

The coagulation process that leads to haemostasis involves a complex set of reactions involving approximately 30 different proteins. These reactions convert fibrinogen to fibrin, which, together with platelets, forms a stable thrombus. Several coagulation cascade models have been proposed, including the intrinsic and extrinsic pathway model and the more recent cell-based model. Building on these models, ongoing research has elucidated a role for other components of the coagulation process including microparticles and the protein P-selectin. An inherited or acquired imbalance in the coagulation system that leads to an increased risk of thrombosis is called thrombophilia. Approximately one in three patients with venous thromboembolism (VTE) has an inherited thrombophilia.


Deep Vein Thrombosis

Deep vein thrombosis (DVT) is usually the formation of a thrombus in the deep veins of the leg, although DVT may also occur in the veins of the upper limbs. DVT can occur spontaneously without a known underlying cause or after provoking events, such as trauma, surgery or acute illness. Complications of DVT include potentially life-threatening pulmonary embolism (PE), as well as post-thrombotic syndrome (PTS). DVT recurs with a relatively high frequency. The Wells’ score, a commonly used clinical score, quantifies the likelihood of an individual patient having DVT. Although a high Wells’ score indicates a clinical probability of DVT, an objective imaging technique, such as compression ultrasonography, must be used to confirm or rule out DVT.


Unfractionated and low molecular weight heparins

Two types of heparins are commonly used as anticoagulants – unfractionated heparin (UFH) and low molecular weight heparins (LMWHs). UFH has been used for the prevention and treatment of thrombosis for several decades. UFH has variable anticoagulant effects and pharmacological properties and also has limited bioavailability and highly variable anticoagulant response. LMWHs are derived from UFH by depolymerization. Each LMWH product has a specific molecular weight distribution that determines its anticoagulant activity and duration of action. LMWHs are associated with a predictable dose–response and have fewer non-haemorrhagic side-effects. Because of these clinical advantages, LMWHs have gradually replaced UFH for most indications.


World Thrombosis Day - What could happen in the next 37Secs

World Thrombosis Day - What could happen in the next 37Secs

What Could happen in the next 37 seconds? Blood clots are the cause of the top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE) however, most blood clots can be prevented or if need be treated. Go to http://www.worldthrombosisday.org to learn the symptoms and risk factors and if you are at risk, talk to your doctor.

What Could happen in the next 37 seconds? Blood clots are the cause of the top three cardiovascular killers: heart attack, stroke and venous thromboembolism (VTE) however, most blood clots can be prevented or if need be treated. Go to http://www.worldthrombosisday.org to learn the symptoms and risk factors and if you are at risk, talk to your doctor.


Arterial Thrombosis

When a thrombus forms within an artery, this is known as an arterial thrombosis. Arterial thrombi usually develop on top of an atherosclerotic plaque and cause myocardial infarction (MI), unstable angina, ischaemic stroke and some manifestations of peripheral arterial disease, such as acute limb ischaemia. Risk factors for arterial thrombosis include smoking, obesity, high blood pressure, increasing age, diabetes and family history. The incidence and prevalence of the clinical manifestations of arterial thrombosis is high. The annual incidence of symptomatic and fatal MI and stroke in the United States (US) in 2010 has been calculated to be 915,000 and 795,000 cases, respectively.


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