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A simple and rapid global haemostatic assay for determination of the overall hemostasis potential (OHP) in plasma represents a new approach in detecting alterations in the delicate balance between coagulation and fibrinolysis. The assay is based on repeated spectrophotometric registration of the fibrin-aggregation curve in platelet-poor plasma containing small amounts of exogenous thrombin, tissue-type plasminogen activator, and calcium. The overall coagulation potential and overall fibrinolytic potential are supplementary parameters of OHP, providing details of underlying changes in coagulation and/or fibrinolysis. The OHP assay was evaluated in connection with hypercoagulation in normal pregnancy, preeclampsia, some thrombophilias, coronary heart disease, diabetes, stroke, and vascular surgery as well as with hypocoagulability, especially in patients with hemophilia A or B. Preliminary results also indicate the possible usefulness of the assay in monitoring anticoagulant treatments. Large prospective clinical trials are needed before the method can be recommended for routine clinical application.