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Glossary

1

Haemostasis

The physiological process that stops bleeding after vessel injury, balancing platelet plug formation, coagulation factor activation and fibrin formation against natural anticoagulant and fibrinolytic pathways. Abnormal haemostasis can present as bleeding or as thrombosis.

2

Thrombosis

Formation of a blood clot inside a vessel or heart chamber while blood is still flowing, obstructing flow. Arterial thrombosis (myocardial infarction, ischaemic stroke) and venous thrombosis are driven by different mechanisms and managed differently.

3

Venous thromboembolism (VTE)

The combined term for deep vein thrombosis (DVT), usually of the legs, and pulmonary embolism (PE), where part of a clot embolises into the pulmonary arteries. VTE is the clinical focus of most anticoagulation research presented at haemostasis congresses.

4

Anticoagulation

Drug therapy that reduces the clotting tendency of blood, used to treat existing thrombosis and to prevent it in atrial fibrillation, after orthopaedic surgery or in thrombophilia. Main classes are heparins, vitamin K antagonists, direct oral anticoagulants and, in specific settings, parenteral direct thrombin inhibitors.

5

Direct oral anticoagulants (DOACs)

Oral agents that inhibit a single coagulation enzyme directly, either factor Xa (apixaban, edoxaban, rivaroxaban) or thrombin (dabigatran). They need no routine INR monitoring, but dose adjustment depends on renal function, age, weight and interacting drugs.

6

Vitamin K antagonist (VKA) and INR

Warfarin and phenprocoumon block vitamin K recycling, reducing functional factors II, VII, IX and X. Therapy is monitored with the international normalised ratio (INR), a standardised prothrombin time that allows results to be compared between laboratories and reagent lots.

7

Von Willebrand disease (VWD)

The most common inherited bleeding disorder, caused by quantitative or qualitative defects of von Willebrand factor, which mediates platelet adhesion and carries factor VIII in plasma. Diagnosis combines bleeding history, VWF antigen, VWF activity and factor VIII testing.

8

Haemophilia A and B

X-linked bleeding disorders caused by deficiency of factor VIII (A) or factor IX (B), historically treated with factor concentrates and increasingly with extended half-life products and non-factor therapies that rebalance haemostasis.

9

Thrombophilia

An inherited or acquired predisposition to thrombosis. Inherited forms include factor V Leiden, prothrombin G20210A, and deficiencies of antithrombin, protein C or protein S; acquired forms include antiphospholipid syndrome and myeloproliferative neoplasms.

10

Antiphospholipid syndrome (APS)

An acquired autoimmune thrombophilia defined by thrombosis or pregnancy morbidity plus persistent antiphospholipid antibodies (lupus anticoagulant, anti-cardiolipin, anti-beta-2-glycoprotein I). Lupus anticoagulant detection is technically demanding because the antibody prolongs phospholipid-dependent clotting times in vitro.

11

Platelet function testing

Laboratory methods that assess how well platelets adhere, activate and aggregate, including light transmission aggregometry, impedance aggregometry, flow cytometry and platelet function analysers used to monitor P2Y12 inhibition or detect inherited platelet disorders.

12

Heparin-induced thrombocytopenia (HIT)

An immune reaction to heparin in which antibodies against platelet factor 4-heparin complexes activate platelets, causing thrombocytopenia and a paradoxically high thrombosis risk. Management is immediate heparin cessation and alternative anticoagulation, not platelet transfusion.

13

Fibrinolysis and thrombolysis

Fibrinolysis is the body's own plasmin-mediated clot breakdown; thrombolysis is its pharmacological acceleration, used in acute ischaemic stroke, massive pulmonary embolism and some thrombosed catheters or prostheses. Antifibrinolytics such as tranexamic acid act in the opposite direction.

14

Coagulation factor concentrate

A plasma-derived or recombinant product containing one or more clotting factors, used to replace deficiency in haemophilia or rare bleeding disorders and, in some protocols, as a haemostatic agent in major bleeding.

15

Thrombin generation assay (TGA)

A global coagulation test that measures the amount of thrombin produced over time in plasma after activation, giving an overall picture of procoagulant and anticoagulant balance rather than a single factor level. Used in research and increasingly in specialised diagnostic laboratories.

16

Point-of-care (POC) coagulation testing

Devices used outside the central laboratory - for example viscoelastic tests such as thromboelastography or rotational thromboelastometry in cardiac and trauma surgery, and capillary INR meters in anticoagulation clinics - to shorten the time between sampling and a treatment decision.