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[Overview of the relevant aspects of the blood coagulation system--focus and cardiovascular hemostasis].

The hemostasis is a complex regulated system. It can be subdivided into the coagulation cascade, the fibrinolytic system, thrombocytes and cellular hemostasis. In atherosclerosis there are several systemic changes of the hemostasis and fibrinolysis, especially in diabetics. These alterations are markedly pronounced in patients with acute complications like acute coronary syndromes. The alterations in these patients constitute a prothrombotic state. To treat this procoagulant situation several drugs like antithrombins, antiplatelet drugs including glycoprotein IIb/IIIa-receptor antagonists, and others are used. This therapy itself can cause perioperative hemostatic disorders. Therefore, a close communication between cardiologist and cardiac surgeon is necessary to handle this complex situation.