Fig. 1
From: Profiles of direct oral anticoagulants and clinical usage—dosage and dose regimen differences
Cell-based coagulation reaction. Tissue factor is revealed in endothelial cells or peripheral monocytes by physicochemical coagulation stimulation, resulting in the formation of a small amount of thrombin, initial thrombin (initial phase). Initial thrombin activates nearby platelets and coagulation factors. Tenase (X-ase) is then formed on the negative-charged phospholipid membrane of activated platelets, and FXa is converted from FX. FXa forms a prothrombinase complex on activated platelets, and thrombin is formed with that complex. This thrombin again activates platelets and coagulation factors (amplification phase), inducing the production of large amounts of FXa and thrombin (propagation phase), resulting in fibrin formation