Hypercoagulable state, pathophysiology, classification and epidemiology : Clinical Chemistry and Laboratory Medicine

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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Schlattmann, Peter / Tate, Jillian R. / Tsongalis, Gregory J.

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Hypercoagulable state, pathophysiology, classification and epidemiology

1 / Igor Alfirević2

1Department of Internal Medicine, Medical School, University Hospital “Sestre Milosrdnice”, Zagreb, Croatia

2Special Hospital for Cardiovascular Surgery and Cardiology “Magdalena” Krapinske Toplice, Croatia

Corresponding author: Zrinka Alfirević, Department of Internal Medicine, Medical School University Hospital “Sestre Milosrdnice”, Vinogradska 29, 10,000 Zagreb, Croatia Phone: +385 98 417 307

Citation Information: Clinical Chemistry and Laboratory Medicine. Volume 48, Pages S15–S26, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2010.371, November 2010

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Hypercoagulable state is not a uniform disease. It is a complex condition with an abnormal propensity for thrombosis that may or may not lead to thrombosis, depending on complex gene-gene and gene-environment interactions. The prevalence of the hypercoagulable state depends on the ethnicity and clinical history of the population being studied. The consequences of a hypercoagulable state due to thrombosis of veins and arteries are the most important cause of sickness and death in developed countries at present. Primary hypercoagulable state is an inherited condition caused by the reduced level of natural anticoagulants due to a qualitative defect or quantitative deficiency of an antithrombotic protein, or increased concentrations or function of coagulation factors. Most of the inherited abnormalities recognized to date have little or no effect on arterial thrombosis and are associated primarily with venous thromboembolism. Arterial thrombosis usually develops as a complication of atherosclerosis and patients usually have more than one traditional risk factor. Secondary hypercoagulable states generally occur as a result of a large number of transient or permanent acquired conditions that increase the tendency for formation of blood clots. New epidemiological data and clinical trials suggest that many acquired risk factors in the pathophysiology of arterial and venous thrombosis overlap and coexist for both disorders.

Clin Chem Lab Med 2010;48:S15–26.

Keywords: acquired conditions; arterial and venous thrombosis; hypercoagulable state; inherited thrombophilia

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