Mechanisms of inhibition of platelet coagulant activity.

The plasma proteinase inhibitors are relatively ineffective in the inhibition of the activity of the platelet prothrombinase complex, due to the low rates of inhibition, and possibly due to the indirect protection from the potentiating effect of the vascular endothelium. The plasma proteinase inhibitors are more effective at inhibiting thrombin, thereby preventing the feedback activation of platelets and factor V and subsequent prothrombinase complex development. This may constitute a mechanism for the control of the development of the prothrombinase complex on the platelet surface. The protein C-thrombomodulin mechanism for the destruction of factor Va activity probably constitutes a major inhibitory mechanism for the prothrombinase complex in vivo.