The hemostatic balance revisited through the lessons of mankind evolution

Massimo Franchini, Pier Mannuccio Mannucci

Research output: Contribution to journalArticlepeer-review


Under physiologic conditions, a hemostatic balance is achieved through the effects of natural procoagulant and anticoagulant factors which, in equilibrium with each other, provide hemostasis at the sites of vascular injury. Abnormalities of these hemostasis factors can result in a tendency toward hemorrhagic or thrombotic events. In this review the influence of inherited prothrombotic risk factors-especially the more frequent factor V Leiden and prothrombin gene mutations-on normal and abnormal hemostasis is analyzed from an evolutionary point of view. The effect of inherited bleeding disorders on the development of thrombotic or atherosclerotic processes is also discussed.

Original languageEnglish
Pages (from-to)3-8
Number of pages6
JournalInternal and Emergency Medicine
Issue number1
Publication statusPublished - Mar 2008


  • Factor V Leiden
  • Hemorrhagic and thrombotic events
  • Hemostasis factors

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine


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