Department of Cardiology, Fuwai Hospital, National Center of Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
Adv Exp Med Biol. 2020;1177:101-131. doi: 10.1007/978-981-15-2517-9_4.
Thrombosis, the localized clotting of blood that affects arterial or venous circulation, is one of the leading causes of death worldwide. Arterial thrombosis is commonly initiated by vascular endothelial injury, while venous thrombosis mainly stems from blood stasis. Despite these differences, platelet adhesion, activation and aggregation, and fibrin formation as a result of coagulation constitute the fundamental processes of thrombus formation. Antithrombotic drugs permitted on the clinical currently can dramatically reduce major adverse cardiovascular events; however, they can also increase the bleeding risk. Discovery of antithrombotic drugs that can effectively prevent thrombosis while sparing bleeding side effects remains unmet medical need. In this chapter, we provide an overview on the pathophysiology of thrombosis, followed by introduction of each class of antithrombotic drugs including their pharmacology, clinical applications and limitations. Practical challenges and future perspectives of antithrombotic drugs are discussed in the last part of this chapter.
血栓形成，即影响动脉或静脉循环的局部血液凝结，是全球范围内主要的死亡原因之一。动脉血栓形成通常由血管内皮损伤引发，而静脉血栓形成主要源于血液淤滞。尽管存在这些差异，但血小板黏附、激活和聚集以及凝血导致的纤维蛋白形成构成了血栓形成的基本过程。目前临床上允许使用的抗血栓药物可显著降低主要不良心血管事件，但也会增加出血风险。因此，发现既能有效预防血栓形成又能避免出血副作用的抗血栓药物仍是未满足的医学需求。在本章中，我们首先概述血栓形成的病理生理学，然后介绍每一类抗血栓药物，包括它们的药理学、临床应用和局限性。最后一部分讨论了抗血栓药物的实际挑战和未来展望。
