FIGURE 38.1 The coagulation cascade (light grey) and the sites of action for the natural anticoagulants (black). PC = protein C, APC = activated protein C. Protein S (PS) is a cofactor for the inhibition of factors V and VIII. TFPI (tissue factor pathway inhibitor) levels increase several fold in response to heparin. TFPI binds to factor VIIa, inhibiting the conversion of factor X to Xa, and factor IX to IXa.
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