Evidence-based Pharmacy Practice (EBPP): HYPERCOAGULABILITY
AbstractPhysiological clot formation hinges on careful synchrony between pro-coagulant, anticoagulant and fibrinolytic forces and when homeostasis is challenged by various extrinsic and intrinsic factors, pathological clot formation (thrombosis) ensues.1 Rudolph Virchow first described thrombotic risk factors according to a triad of aetiologies (Virchow’s triad)2, essentially attributing pathological clot formation to venous stasis, blood vessel abnormalities or defects in coagulation. While the first two factors are usually clinically apparent from a history-taking and physical examination, the third factor of Virchow, delineating familial or acquired defects in coagulation are not always immediately evident. This clinical entity, encompassing both inherited and acquired predilections to clot formation and often associated with idiopathic thrombosis in patients below the age of 45 years, is known as hypercoagulability or thrombophilia.3,4 Although recent advances in molecular genetics have led to the identification of new thrombophilic aetiologies in the last 20 years and greater elucidation of the pathophysiologies of known causes, this risk factor remains the least understood of the triad.5,6
Evidence-Based Pharmaceutical Practice
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