Thrombin bound to fibrin or fibrin degradation products is protected from being inhibited by AT-heparin but is susceptible to inactivation by DTIs (Weitz and Buller, 2002). Thus, DTIs block both free and fibrin-bound thrombin, which is an important theoretical advantage over heparin because fibrin-bound thrombin can continue to promote thrombus formation. Because DTIs do not bind plasma proteins, they also produce a more predictable anticoagulant response than heparin (Weitz and Buller, 2002).

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