Abstract
In the 19th century Virchow postulated that thrombosis was caused by alteration in the vessel wall, blood flow, or the composition of the blood. 1 Virchow R Phlogose und Thrombose im Gefäβsystem. Gesammelte Abhandlungen zur Wissenschaftlichen Medizin. Staatsdruckerei, Frankfurt1856 Google Scholar In 1958, Åstrup hypothesised a tonic thrombohaemorrhagic balance, characterised by a steady-state between clot formation and dissolution. 2 Åstrup T The haemostatic balance. Thromb Diath Haemorrh (Stutt). 1958; 2: 347-357 PubMed Google Scholar Changes in this steady-state (eg, in the components of Virchow's triad) tip the balance towards thrombosis. Concentrations of activation peptides generated by the activity of coagulation enzymes and of enzyme-inhibitor complexes reveal the state of tonic activation, with evidence for increased activation in myocardial infarction, stroke, and venous thrombosis. Activation markers of coagulation and fibrinolysis in twins: heritability of the prethrombotic stateThe activation mechanisms of the coagulation and fibrinolytic systems, and therefore the prethrombotic state, are controlled to a substantial degree by genetic factors. Genes influencing activation of haemostasis are likely to be an important component of the overall thrombotic tendency in the general population. Full-Text PDF
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