Thrombin is a key clot promoter. Thrombin is an enzyme that presides over the conversion of a substance called fibrinogen to fibrin, which helps form a blood clot. Thrombin is has been widely characterized for its roles in hemostasis, inflammation, and cell signaling.
Natural Supplements that have anti-clotting ability
Certain supplements have blood thinning potential and should be
considered by doctors as a way to reduce the risk for blood clots. These natural supplements include:
EGCG, the extract from
green tea, may prevent platelet aggregation almost as potently as aspirin
Fish oils thin the
blood and have many other benefits
Garlic could be helpful
Vitamin E may reduce the risk of blood clots in women, such as venous
thromboembolism.
Ginger is a very healthy herb to eat daily
and has mild anti platelet activity along with the ability to break down fibrin.
Ginkgo biloba herbal
extract
Nattokinase enzyme has
fibrinolytic activity. You can find
Nattokinase here. Only use nattokinase under medical supervision.
Onion
This is
a partial list.
Thrombin use in Surgery
Thrombin has been purified from numerous sources and used as a clinical aid for topical hemostasis for more than 60 years. Due to both its ease of use and apparent effectiveness, thrombin has become used routinely as an aid for topical hemostasis in nearly all types of surgical procedures, including but not limited to cardiovascular, orthopedic, neurologic, general, gynecologic, and dental procedures.
Direct thrombin inhibitor
Direct thrombin
inhibitors such as bivalirudin, lepirudin, and argatroban are a new class of
anticoagulants. The mechanism of action of these agents differs from heparin in
that they directly inhibit the active site of thrombin, and they do not require
an interaction with antithrombin III to produce their anticoagulant effect.
Furthermore, contrary to heparin, direct thrombin inhibitor agents inhibit only
the activity of thrombin whereas heparin, through its activation of antithrombin
III, indirectly inhibits factors IIa (thrombin), Xa, IXa, XIa and XIIa.
Thromboembolism is a common cause of death and
disability. Heparin or warfarin, the current standard management for
thromboembolism may cause serious bleeding complications. Hirudin, the most
potent natural thrombin -specific inhibitor, was first isolated from leech
salivary fluid. Synthetic thrombin -specific inhibitors are rationally designed
based on the knowledge on the structures of the activate site of thrombin.
Thrombin -specific inhibitors are the current best choice for the treatment of
heparin-induced thrombocytopenia (HIT). Bivalirudin (hirulog-1 or Angiomax), in
adjunct to aspirin, was approved for prevention of thrombosis in patients with
unstable angina following angioplasty. Argatroban has been used for the
treatment of HIT, peripheral and cerebral thrombotic diseases.
Two parenteral direct thrombin inhibitors, lepirudin and argatroban, have FDA approval for the management of heparin-induced thrombocytopenia. Ximelagatran, an oral prodrug of the direct thrombin inhibitor melagatran, has shown efficacy in the prevention and treatment of venous thromboembolism as well as stroke prevention in patients with atrial fibrillation. Fondaparinux is a synthetic pentasaccharide, which binds to antithrombin, thereby indirectly selectively inhibiting factor Xa. Fondaparinux is FDA approved for the prevention and treatment of venous thromboembolism.
Thrombin time
Thrombin time compares a patient's rate of clot formation to that of a sample of normal pooled plasma. Thrombin is added to the samples of plasma. If the plasma does not clot immediately, a fibrinogen deficiency is present. The thrombin time is used to diagnose bleeding disorders and to assess the effectiveness of fibrinolytic therapy. Reference values for thrombin time are 10 to 15 seconds or within 5 seconds of the control.
Level pro thrombin
The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. They are used to determine the clotting tendency of blood, in the measure of warfarin dosage, liver damage and vitamin K status. The reference range for prothrombin time is usually around 12-15 seconds; the normal range for the INR is 0.8-1.2. It is used in conjunction with the activated partial thromboplastin time (aPTT) which measures the intrinsic pathway.
Thrombin level and Deep Vein Thrombosis
Measurement of thrombin generation, using a commercially available assay, can identify patients who are not likely to experience recurrent venous thromboembolism (VTE) and, therefore, may not require long-term anticoagulation therapy. After experiencing a VTE, patients typically receive anticoagulation with a vitamin K antagonist for at least 3 to 6 months. Unfortunately, after stopping this therapy, up to one third of patients will experience a recurrence, which carries a fatality rate of about 5%. A primary goal of thrombosis research is finding a way to separate the patients destined for a recurrence from those who will have no further problems. Being able to discriminate between these groups could markedly reduce the use of anticoagulation therapy and all of its well-known risks. Thrombin generation is significantly lower in patients who remain clot-free during follow-up. Compared with thrombin generation greater than 400 nM, values between 400 and 300 nM and below 300 nM cut the risk of recurrence by 58% and 63%, respectively. There is no thrombin generation value that completely ruled out the possibility of recurrent clots.
Argatroban - Direct Thrombin Inhibitor
Heparin has historically been used as the anticoagulant of choice in the management of a number of thrombotic diseases. Recognition of the limitations of heparin has led to the development of a newer class of anticoagulants, the direct thrombin inhibitors. Argatroban is a synthetic small molecule that selectively inhibits thrombin at its active site. In clinical trials, argatroban has been shown to be an effective anticoagulant in patients undergoing percutaneous coronary interventions. In patients with heparin-induced thrombocytopenia and heparin-induced thrombocytopenia complicated by thrombosis, argatroban significantly decreases the risk of thrombotic events.