To clot, or not to clot – Antithrombotic therapy is the question

Keywords: anticoagulant, antiplatelet, direct oral anticoagulants (DOACs), haemostasis, thromboembolism, thrombolytic therapy, vitamin K antagonists


Haemostasis and thrombosis rely on three components, namely the vascular endothelial wall, blood platelets and the coagulation cascade. Nonphysiologic excessive thrombosis occurs when haemostatic processes are dysfunctional, causing undue clot formation or reduced clot lysis. Antithrombotic agents including antiplatelet, anticoagulation and fibrinolytic agents are essential for the prophylaxis and pharmacological management of venous thromboembolism and arterial thrombosis. Anticoagulation treatment options have expanded steadily over the past few decades, providing a greater number of agents. Anticoagulants that directly target the enzymatic activity of thrombin and factor Xa have recently been developed to address the inadequacies of traditional vitamin K antagonists. Appropriate use of these agents requires knowledge of their individual characteristics, risks, and benefits.

Author Biographies

E Osuch, Sefako Makgatho Health Sciences University

Department of Pharmacology and Therapeutics, School of Medicine, Sefako Makgatho Health Sciences University, South Africa

A Marais, University of Pretoria

Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa