TY - CHAP M1 - Book, Section TI - Antithrombin Therapies A1 - Gupta, Vedant A. A1 - Moliterno, David J. A2 - Samady, Habib A2 - Fearon, William F. A2 - Yeung, Alan C. A2 - King III, Spencer B. PY - 2017 T2 - Interventional Cardiology, 2e AB - Acute coronary artery occlusion is a dynamic process that involves three essential processes: compromise of vascular integrity, platelet activation and aggregation, and acceleration of the coagulation cascade with fibrin formation. Although the role of thrombin (factor IIa) is well documented in blood coagulation, fibrin formation, and thrombus stabilization, it is also central to interplay among these processes. Angiographic, intravascular ultrasound (IVUS), and pathologic studies during acute coronary syndromes (ACS) have helped delineate the pathophysiology of coronary artery occlusion: atherosclerotic plaque rupture leads to release of tissue factor (TF), which has broad impact to stimulate platelets and generate thrombin. TF activates factor VII, which activates the common pathway via the extrinsic pathway, and also activates factor IX, activating the intrinsic pathway (Fig. 15-1).1 Subsequent generation of factor Xa leads to thrombin activation. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/10 UR - accesscardiology.mhmedical.com/content.aspx?aid=1146596314 ER -