Alternative thrombotic therapy

Abstract

Thrombotic disease is very much a Twentieth Century killer. Epidemiological studies have established its effect both in terms of decreasing the quality of life and in the ever increasing number of fatalities. Numerous risk factors and risk groups have been identified not least of which is increasing age. This is frequently reflected in the number of elderly patients attending anticoagulant clinics of which Malta is no exception. Traditional therapy has by in large concentrated on the use of warfarin as a first line drug in preventing recurrent thrombotic episodes. The action of warfarin is however not specifically directed against the active site of coagulation proteinases but rather inhibits a post ribosomal carboxylation of vitamin K dependent clotting factors which leads to a decrease in the amount of thrombin the body can generate per unit time.