[Where to look for progress in antithrombotic treatments?].

Thrombosis is the most frequent cause of venous and arterial vascular events. Anticoagulants and antiplatelet agents are able to prevent both types of thrombotic episodes. However, available agents have limitations which justify the search for new antithrombotic drugs or at least the clinical investigation of combined treatment with already available drugs. Progress in the knowledge of the mechanism of thrombosis guides the search for new antithrombotic agents. Novel strategies should take into account the intensity of the thrombogenic stimulus involved in the occurrence of the thrombotic episodes. Among antiplatelet agents, the logic combination of aspirin and ticlopidine or clopidogrel is already challenging the anti-GP IIb/IIIa orally active compounds. Among anticoagulant agents a long list of competitors for the replacement of oral anticoagulants and heparins is already available. They target factors Xa, IIa or VIIa. A promising alternative is to increase the thromboresistance of the vascular wall.