The role of thrombin in coronary artery thrombosis.

The critical role of thrombin in mediating platelet-rich thrombosis has been defined extensively in experimental and, more recently, clinical studies. The results of these studies suggest that the extent of thrombin activity after atherosclerotic plaque rupture is dependent on tissue factor-mediated activation of the coagulation system and activation of factor Xa. Local factor Xa-Va complex activity, in turn, is dependent on platelet adhesion and activation, which are potentiated by thrombin. Thus, the initiation and progression of coronary artery thrombosis seems to be dependent on a dynamic interaction between procoagulant and platelet-related factors that result in the elaboration of thrombin and platelet-rich thrombosis.