Measurement of thrombosis and its prevention: Measurement of thrombosis

Thrombosis remains the commonest cause of death (including premature death) in developed countries, and is a growing epidemic in developing countries because of increasing prevalence of smoking, obesity, hypertension and type 2 diabetes. Primary and secondary prevention of thrombosis is therefore an important part of public health, and primary and secondary healthcare. In addition to public and individual education (and management) of smoking, exercise, obesity, hypertension, diabetes and hypercholesterolaemia) antithrombotic drugs have an important role. In recent years, many randomized controlled trials have not only clarified the antithrombotic benefits (and bleeding risks) of traditional antiplatelets (aspirin), anticoagulants (unfractionated heparin, warfarin) and thrombolytics (streptokinase) but have also investigated the role of newer antithrombotics. Evidence-based guidelines on antithrombotic therapy are now reviewed every few years, to keep pace with advances in knowledge from new trials, and epidemiological studies [1–3]. This review considers the nature of thrombosis, antithrombotic therapies, the endpoints used in such studies, and the potential use of blood thrombotic markers in predicting persons at increased thrombotic risk.