Blood clotting is the physiological process that, once a blood vessel wall is damaged or altered, causes the blood to clot. This avoids or limits the extent of a haemorrhage and involves a vascular phase and a platelet phase (primary hemostasis) followed by a coagulation phase (secondary hemostasis).
The blood clotting process is unique, but can be divided into a physiological version known as hemostasis, in which the vessel wound is plugged and repaired, and a pathological version, thrombosis, when obstructive clotting occurs, which can have serious consequences for the patient, such as cardiovascular diseases and ischemic cerebrovascular disease.
The video portrays a very common condition: the way a parietal thrombus forms around plaques of cholesterol. Over time, the thrombus grows to the point of significantly limiting the flow of blood through the vessel or blocking it completely. If the vessel belongs to the cardiovascular system, the blockage causes a heart attack.
Cardiovascular diseases are the main cause of death in Europe. In Italy, they cause 35% of male deaths and 43% of female deaths. They have a huge impact on public health and weigh heavily on health and economic resources.In Italy alone, spending on cardiovascular surgery is estimated at approximately €650 million. Over €5 billion is spent on medication for these disorders.
At European level, the European Society of Cardiology and the European Heart Network have calculated that the treatment of cardiovascular diseases costs Europe over 196 billion a year, with health costs that vary from 4% in Luxembourg to 17% in Estonia, Latvia and Poland.
Despite significant progress in diagnosis and treatment, heart disease is still one of the main causes of death in the world. According to data from the World Health Organisation (2008), more than 17 million deaths a year are caused by cardiovascular diseases which are classified as ‘silent killers‘, generally asymptomatic, until a serious cardiovascular event occurs.
Source of data: ISTAT
At the end of 2013, AIFA, the Italian Medicines Agency, notably asked all doctors to pay particular attention when prescribing novel oral anticoagulant drugs. These drugs, used in alternative to Coumadin (warfarin) have some advantages but they may need still to take advantage of laboratory monitoring.
Source of data: AIFA
Anticoagulation therapies, including consolidated anticoagulants like Coumadin (warfarin), are used for prophylaxis in surgery and to treat both directly and indirectly thrombotic diseases (thrombosis, strokes, myocardial infarctions, neoplasms, hypercholesterolemia, diabetes, etc.).
That is why it is essential to customise the dosage, to contain the risks of bleeding and other side effects that can be taxing on the patient.
In Italy, strokes are the third biggest cause of death, after coronary heart diseases and neoplasms; they cause 10-12% of all deaths every year and are the main cause of disability. Every year in Italy there are around 196,000 cases of stroke, of which 20% are relapses. 10-20% of those who suffer cerebral strokes die within a month and another 10% within a year. Only 25% of patients who survive strokes make a full recovery, and 75% survive with some form of disability, half of which suffer from a disability so severe that they lose their self-sufficiency.
Source of data: MINISTERY of HEALTH