Volume 11, Number 3

Paul Harrison BSc PhD MRCPath Clinical Scientist and Honorary Lecturer, Oxford Haemophilia Centre and Thrombosis Unit, Churchill Hospital, Oxford

As platelets are firmly implicated in the pathology of atherosclerosis and arterial thrombosis, antiplatelet therapy forms an important and effective component of both treatment and prophylactic strategies. Many established antiplatelet drugs are traditionally administered at standard doses without monitoring of their efficacy.

David Fitzmaurice FRCGP MD Professor of Primary Care Research, Department of General Practice, The Medical School, Birmingham; Ellen Murray PhD Research Fellow, Department of Primary Care, University of Birmingham

The last 20 years have seen a revolution in service delivery for patients receiving oral anticoagulation therapy, principally warfarin, in the UK. The main driver for this revolution has been the increasing number of patients with atrial fibrillation who are receiving warfarin as thromboprophylaxis. There is compelling evidence for the use of warfarin in atrial fibrillation, with a reduction in stroke rates of about 60% and a reduction in mortality of about 40%.

Catherine N Bagot MD MRCP Specialist Registrar in Haematology; Raj K Patel MD MRCP MRCPath Consultant Haematologist; Roopen Arya MA PhD FRCP FRCPath Consultant Haematologist, King’s College Hospital, London

Venous thrombosis in the portal, mesenteric and hepatic veins are rare but severe conditions often affecting young patients. Thrombosis of the hepatic veins results in Budd–Chiari syndrome (BCS), which has a heterogeneous clinical presentation. Portal vein thrombosis (PVT) presents with complications of portal hypertension.

Vikramajit Singh MRCP Specialist Registrar (LAT) in Haematology, Christie Hospital, Manchester; Paneesha Shankaranarayana MRCP MRCPath Clinical Research Fellow in Haematology; Peter Rose FRCP FRCPath Consultant Haematologist, Warwick Hospital, Warwick

In 1856, Rudolph Virchow identified three primary risk factors – classically described as Virchow’s triad – for venous thromboembolism (VTE): venous stasis, hypercoagulability, and endothelial injury. Since then, many other risk factors have been identified. The magnitude of these vary, and the independence of each is, at best, uncertain.

Ian Jennings PhD CSci FIBMS Scientific Programme Manager, UK National External Quality Assessment Scheme for Blood Coagulation, Sheffield

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the Western world, with an annual incidence in the general population estimated to be 1:1,000. A number of factors, both inherited and acquired, are known to increase the risk of thrombosis.