Coagulation and platelet activation pathways. A review of the key components and the way in which these can be manipulated.

Acute coronary syndromes are caused by thrombotic obstruction of usually diseased arteries. The thrombotic plug consists of platelets and fibrin. Until recently only three antithrombotic drugs, aspirin, heparin and dicumarol were available for the prevention and treatment of acute coronary syndromes. A better understanding of the cellular and humoral mechanisms underlying these syndromes has broadened the arsenal of antithrombotic drugs dramatically. In this review the physiological activation process of platelets and the coagulation cascade are discussed. Furthermore, the ways in which these processes can be therapeutically manipulated are reviewed.