Thrombotic preparedness in aging: a translatable construct for thrombophilias?
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The association between aging and atherothrombotic phenotypes, to include myocardial infarction and ischemic stroke, is well described and represents a phenomenon of heightened societal relevance given the progressive increase in life-expectancy in western societies. Fundamentally, the prothrombotic state of aging displays teleological similarities to other conditions wherein hemostatic challenges are anticipated and, in essence, prepared for through several related molecular and biological mechanisms. In aging, however, maladaptive vascular responses mediated by impaired endothelial cell regenerative capacity, cause a dangerous shift toward thrombosis that persists and is further augmented over time. A common and unifying theme of vascular injury and faulty repair in all likelihood participates directly in concomitant thrombotic and hemorrhagic risk among older individuals as well. Accordingly, therapies designed to prevent vascular injury, restore reparative capacity or both, may be...