Factor XI Inhibition to Uncouple Thrombosis From Hemostasis: JACC Review Topic of the Week

Hemostasis and thrombosis are believed to be so intricately linked that any strategies that reduce thrombosis will have an inevitable impact on hemostasis. Consequently, bleeding is viewed as an unavoidable side effect of anticoagulant therapy. Emerging evidence suggests that factor XI is important...

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Veröffentlicht in:Journal of the American College of Cardiology 2021-08, Vol.78 (6), p.625-631
Hauptverfasser: Hsu, Charles, Hutt, Edward, Bloomfield, Daniel M, Gailani, David, Weitz, Jeffrey I
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container_issue 6
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container_title Journal of the American College of Cardiology
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creator Hsu, Charles
Hutt, Edward
Bloomfield, Daniel M
Gailani, David
Weitz, Jeffrey I
description Hemostasis and thrombosis are believed to be so intricately linked that any strategies that reduce thrombosis will have an inevitable impact on hemostasis. Consequently, bleeding is viewed as an unavoidable side effect of anticoagulant therapy. Emerging evidence suggests that factor XI is important for thrombosis but has a minor role in hemostasis. This information raises the possibility that anticoagulants that target factor XI will be safer than currently available agents. The authors provide a visual representation of the coagulation pathways that distinguishes between the steps involved in thrombosis and hemostasis to explain why factor XI inhibitors may serve as hemostasis-sparing anticoagulants. A safer class of anticoagulants would provide opportunities for treatment of a wider range of patients, including those at high risk for bleeding. Ongoing clinical studies will determine the extent to which factor XI inhibitors attenuate thrombosis without disruption of hemostasis.
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subjects Blood Coagulation - drug effects
Blood Coagulation - physiology
Factor Xa Inhibitors - pharmacology
Hemostasis - drug effects
Hemostasis - physiology
Humans
Thrombosis - blood
Thrombosis - drug therapy
title Factor XI Inhibition to Uncouple Thrombosis From Hemostasis: JACC Review Topic of the Week
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