Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

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Advances in Clinical and Experimental Medicine

2006, vol. 15, nr 4, July-August, p. 655–662

Publication type: review article

Language: Polish

Ocena bezpośrednich inhibitorów trombiny na tle nowego modelu układu krzepnięcia

New Direct Thrombin Inhibitors in the Light of New Model of Coagulation Cascade

Roman Mycka1,, Edyta Sutkowska2,, Krzysztof Sutkowski3,

1 Oddział Kardiologii SP Szpitala Wojewódzkiego w Gorzowie Wlkp.

2 Klinika Angiologii, Nadciśnienia Tętniczego i Diabetologii AM we Wrocławiu

3 Klinika Chirurgii Ogólnej, Gastroenterologicznej i Endokrynologicznej AM we Wrocławiu

Streszczenie

Artykuł przedstawia aktualne poglądy dotyczące szlaków aktywacji krzepnięcia ze szczególnym uwzględnieniem, kluczowej w tym procesie, roli trombiny. Poznanie procesów, dzięki którym dochodzi do wytwarzania i aktywacji trombiny jest konieczne do zrozumienia mechanizmów rządzących układem krzepnięcia. W ostatnich latach dokonał się istotny postęp w rozumieniu tych procesów, dzięki czemu możliwe stało się wprowadzenie na rynek wielu nowych leków, między innymi, biwalirudyny – bezpośredniego inhibitora trombiny, który dzięki swoim unikatowym właściwościom może zastąpić heparynę, stając się lekiem z wyboru podczas angioplastyk tętnic wieńcowych.

Abstract

Coagulation is a process which protects the organism from excessive blood loss. The generation of thrombin from prothrombin is the central event of the blood coagulation process, which is essential to thrombosis. Thrombin is a potent platelet agonist, and recent data indicate that it may be the most critical activator of tissue−induced thrombosis. It is produced by a complex series of proteolytic events. This is dynamic process in which thrombin itself plays many roles. A minute quantity of thrombin generated at the site of arterial injury activates platelets and amplifies its own production, resulting in an explosive burst of thrombin production. Along with a clearer understanding of the biology of thrombosis and hemostasis, better methods for studying the mechanisms of coagulation and platelet activation have provided a new understanding of the methods by which antithrombotic agents work. Bivalirudin is a thrombin−specific anticoagulant, which directly and reversably inhibits both clot−bound and circulating thrombin. So, it has the potential to replace heparin and become the anticoagulant of choice during percutaneous coronary intervention.

Słowa kluczowe

układ krzepnięcia, trombina, bezpośrednie inhibitory trombiny

Key words

coagulation, thrombosis, thrombin, direct thrombin inhibitors

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