Figure. Coagulation cascade illustrating different points of intervention of current anticoagulants and a potential factor XIII/fibrin crosslinking inhibitor.

Current anticoagulants target enzymes leading to thrombin generation and therefore, interfere with fibrin formation. Blocking factor XIII(a) activity would permit normal fibrin formation, but reduce fibrin stability, red blood cell retention in thrombi, and thrombus size. In this way, factor XIII(a) inhibition would be mechanistically different from existing approaches. TF, tissue factor.