[Coagulation factor VII--new physiopathological and therapeutic aspects].

Factor VII (FVII) is a vitamin K dependent coagulation factor that is synthesized in the liver, where clearance of the unactivated protein also takes place. It is a glycoprotein that following activation plays an important role in initiating coagulation after complex formation with tissue factor. A revised hypothesis of blood coagulation implicating the requirement of intact extrinsic and intrinsic pathways is presented. Increased activity of factor VII is associated with atherogenesis, and FVII deficiency may cause bleeding disorders. Recombinant FVIIa (rFVIIa) may be used in the treatment of haemophilic patients with antibodies against factor VIII or factor IX, utilizing its direct action in activation of factor X. Ongoing studies are investigating whether rFVIIa can shorten the bleeding time in patients with thrombocytopenia.