THROMBIN - STRUCTURE, BIOCHEMISTRY, MEASUREMENT, AND STATUS IN CLINICAL MEDICINE

Thrombin remains a molecule of great interest to scientists and clinic ians alike because of its important role in hemostasis, thrombosis, in flammation and vascular remodeling. Yet one of the great challenges ha s been the inhibition of thrombin generation to a degree that minimize s intravascular thrombosis while preserving physiologic hemostasis. It has become increasingly clear that high levels of anticoagulation wit h either direct or indirect thrombin antagonists are not beneficial an d, in fact, are quite detrimental. Despite the overwhelming shift of i nterest toward the platelet in clinical trials of acute coronary syndr omes, much can be gained through further investigation of coagulation processes responsible for thrombin generation and activity.