Prothrombin fragment 1+2
F2proteinF1+2 release quantifies activated prothrombin conversion, reflecting the rate of thrombin generation and coagulation activation.
Pathway placement
Cascade stepCoagulation & thrombus formation
Confidencehigh
RationaleDirect marker of factor Xa activity and thrombin generation in the tissue-factor-triggered cascade.
Also acts inMyocardial injury
Druggability
DruggableYes
Known drugs / candidates14
Small-molecule tractableYes
Antibody tractableYes
EnsemblENSG00000180210
Type I vs Type II discrimination
ScoresShared / rises in both
R — rupture / Type-I67
C — confounder / Type-II56
A — assay feasibility84
E — evidence strength60
T1DI (composite)28
Specificity differential (R−C)+11.1
Confounder panel (Type-II drivers)
1sepsis / systemic inflammationmag 2
2anemia / acute blood lossn/a
3hypovolemia / dehydrationn/a
4tachyarrhythmiamag 1
5hypoxemia / respiratory failuren/a
6hypertensive emergencymag 2
7high-demand / peri-operative stressn/a
Coverage: 3/7 confounders with evidence
Tier: deep-scored (abstract-extracted) · 12 supporting references. See the discrimination table for all markers.
Assay & specimen
Validated clinical assay
Specimen
Platelet-poor plasma
Collection tube
Sodium citrate 3.2% (light blue-top)
Method / principle
Clotting assay (PT-based factor II) or calibrated automated thrombography
Reagent / substrate
Thromboplastin / fluorogenic thrombin substrate + tissue factor trigger
Platform
Coagulation analyzer / CAT fluorometer
Turnaround · availability
Routine–research · Clinical (factor II); research (thrombin generation)
Human genetic evidence
0.327
Open Targets association (acute_MI)
Literature evidence(53)
- Combined complement and coagulation activation in ST-elevation myocardial infarction: associations with myocardial injury and dysfunction.Frontiers in immunology · 2025 · PMID 41262246 · doi
- Proteomics of urinary exosomes for discovering novel non-invasive biomarkers of acute myocardial infarction patients.International journal of biological macromolecules · 2025 · PMID 39890005 · doi
- Differential effects of physiological agonists on the proteome of platelet-derived extracellular vesicles.Proteomics · 2024 · PMID 38556629 · doi
- Quantitative proteomics reveal three potential biomarkers for risk assessment of acute myocardial infarction.Bioengineered · 2022 · PMID 35156527 · doi
- Validation of an admission coagulation panel for risk stratification of COVID-19 patients.PloS one · 2021 · PMID 33740793 · doi
- Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016 · PMID 27003690 · doi
- Portal vein thrombosis in cirrhosis is not associated with intestinal barrier disruption or increased platelet aggregability.Clinics and research in hepatology and gastroenterology · 2016 · PMID 27160816 · doi
- Inflammatory and thrombotic markers in patients with ST-elevation myocardial infarction treated with thrombolysis and early PCI: a NORDISTEMI substudy.Thrombosis research · 2012 · PMID 22607887 · doi
- Platelet activation, coagulation activation and C-reactive protein in simultaneous samples from the vascular access and peripheral veins of haemodialysis patients.International journal of laboratory hematology · 2011 · PMID 21722325 · doi
- Thrombin formation and platelet activation at the site of vascular injury in patients with coronary artery disease treated with clopidogrel combined with aspirin.Kardiologia polska · 2009 · PMID 19618315
- Early decrease in coagulation activity after myocardial infarction is associated with lower risk of new ischaemic events: observations from the ESTEEM Trial.European heart journal · 2007 · PMID 17314111 · doi
- Heparin immobilization reduces thrombogenicity of small-caliber expanded polytetrafluoroethylene grafts.Journal of vascular surgery · 2006 · PMID 16520178 · doi
- Long-term treatment with ximelagatran, an oral direct thrombin inhibitor, persistently reduces the coagulation activity after a myocardial infarction.Journal of thrombosis and haemostasis : JTH · 2005 · PMID 16194202 · doi
- Increased levels of soluble tissue factor during long-term treatment with warfarin in patients after an acute myocardial infarction.Journal of thrombosis and haemostasis : JTH · 2004 · PMID 15099277 · doi
- Increases in circulating levels of monocyte-platelet and neutrophil-platelet complexes following hip arthroplasty.Clinical science (London, England : 1979) · 2002 · PMID 11869168
- Hemostatic markers in patients at risk of cerebral ischemia.Stroke · 2000 · PMID 10926947 · doi
- Reactivation of coagulation after stopping infusions of recombinant hirudin and unfractionated heparin in unstable angina and myocardial infarction without ST elevation: results of a randomized trial. OASIS Pilot Study Investigators. Organization to Assess Strategies for Ischemic++ Syndromes.European heart journal · 2000 · PMID 10952840 · doi
- Prothrombotic genetic risk factors in young survivors of myocardial infarction.Blood · 1999 · PMID 10381497
- Thrombin generation, inhibition and clinical outcomes in patients with acute myocardial infarction treated with thrombolytic therapy and heparin: results from the GUSTO-I Trial. GUSTO-I Hemostasis Substudy Group. Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries.Journal of the American College of Cardiology · 1998 · PMID 9502626 · doi
- Activation of coagulation and fibrinolysis after rehabilitative exercise in patients with coronary artery disease.The American journal of cardiology · 1998 · PMID 9527072 · doi
- Persistent thrombin generation during heparin therapy in patients with acute coronary syndromes.Arteriosclerosis, thrombosis, and vascular biology · 1997 · PMID 9261263 · doi
- Association of heparin-resistant thrombin activity with acute ischemic complications of coronary interventions.Circulation · 1996 · PMID 8901652 · doi
- Rebound after cessation of oral anticoagulant therapy: the biochemical evidence.British journal of haematology · 1996 · PMID 8603020 · doi
- Relationship between intracoronary thrombolysis and fibrino-coagulation--special reference to TAT/PIC and FPA/PIC.Japanese circulation journal · 1996 · PMID 8741240 · doi
- Rebound increase in thrombin generation and activity after cessation of intravenous heparin in patients with acute coronary syndromes.Circulation · 1995 · PMID 7895349 · doi
- Persistent activation of coagulation mechanism in unstable angina and myocardial infarction.Circulation · 1994 · PMID 8026047 · doi
- Serial changes in coagulant activities after thrombolytic therapy for acute myocardial infarction.Angiology · 1994 · PMID 8161005 · doi
- Hemostatic abnormalities in acute myocardial infarction as detected by specific blood markers.Thrombosis research · 1994 · PMID 7863479 · doi
- Persistent generation of thrombin after acute myocardial infarction.Arteriosclerosis and thrombosis : a journal of vascular biology · 1992 · PMID 1576116 · doi
- Coagulation Markers and Myocardial Blush Grade in STEMI: Identifying Potential Predictors of Microvascular Reperfusion.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2026 · PMID 41549721 · doi
- Biomarkers of Thrombosis in ST-Segment Elevation Myocardial Infarction: A Substudy of the ATOLL Trial Comparing Enoxaparin Versus Unfractionated Heparin.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2018 · PMID 30144017 · doi
- Urinary prothrombin fragment 1+2 in patients with venous thrombosis and myocardial infarction.Journal of thrombosis and thrombolysis · 2013 · PMID 23263991 · doi
- Platelet depletion, platelet activation and coagulation during treatment with hemodialysis.Scandinavian journal of clinical and laboratory investigation · 2011 · PMID 21303224 · doi
- Is fibrin formation and thrombin generation increased during and after an acute coronary syndrome?Thrombosis research · 2011 · PMID 21496882 · doi
- Coagulation, fibrinolysis, and platelet activation in patients undergoing open and endovascular repair of abdominal aortic aneurysm.Journal of vascular surgery · 2011 · PMID 21684711 · doi
- Effect of apixaban, an oral and direct factor Xa inhibitor, on coagulation activity biomarkers following acute coronary syndrome.Thrombosis and haemostasis · 2010 · PMID 20806117 · doi
- Active tissue factor and activated factor XI in circulating blood of patients with systolic heart failure due to ischemic cardiomyopathy.Polskie Archiwum Medycyny Wewnetrznej · 2010 · PMID 20864906
- Thrombin activity throughout the acute phase of acute ST-elevation myocardial infarction and the relation to outcome.Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals · 2009 · PMID 19552570 · doi
- Assessment of markers of thrombin generation in patients with acute myocardial infarction complicated by ventricular fibrillation.Clinical cardiology · 2006 · PMID 16649726 · doi
- Plasma markers of activated hemostasis in the early diagnosis of acute coronary syndromes.Clinica chimica acta; international journal of clinical chemistry · 2006 · PMID 16696962 · doi
- Tissue factor pathway inhibitor, natural coagulation inhibitors and hemostatic activation markers in patients with acute coronary syndromes.Saudi medical journal · 2005 · PMID 15983678
- Coagulation indicators in chronic stable effort angina and unstable angina: relationship with acute phase reactants and clinical outcome.Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis · 2002 · PMID 11943939 · doi
- Inflammation, fibrinogen and thrombin generation in patients with previous myocardial infarction.Haematologica · 2002 · PMID 12091125
- Thrombogenesis in sickle cell disease.The Journal of laboratory and clinical medicine · 2001 · PMID 11385360 · doi
- Coagulation activity and clinical outcome in unstable coronary artery disease.Arteriosclerosis, thrombosis, and vascular biology · 2001 · PMID 11397720 · doi
- Relationships between homocysteine, factor VIIa, and thrombin generation in acute coronary syndromes.Circulation · 2000 · PMID 10653827 · doi
- Prognostic significance of elevated hemostatic markers in patients with acute myocardial infarction.Journal of the American College of Cardiology · 1999 · PMID 10334421 · doi
- Study on the hypercoagulable state in patients with angina and myocardial infarction.Journal of Tongji Medical University = Tong ji yi ke da xue xue bao · 1998 · PMID 10806795 · doi
- Low-molecular weight heparin reduces the generation and activity of thrombin in unstable coronary artery disease.Thrombosis and haemostasis · 1998 · PMID 9531028
- Useful laboratory tests for studying thrombogenesis in acute cardiac syndromes.Clinical chemistry · 1998 · PMID 9702994
- Procoagulant and proinflammatory activity in acute coronary syndromes.Cardiovascular research · 1998 · PMID 9893733 · doi
- Complete heparin-coated (CBAS) cardiopulmonary bypass and reduced systemic heparin dose; effects on coagulation and fibrinolysis.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 1996 · PMID 8817142 · doi
- Thrombin generation and activity during thrombolysis and concomitant heparin therapy in patients with acute myocardial infarction.Journal of the American College of Cardiology · 1995 · PMID 7798503 · doi