The anticoagulant effect of protamine is greatly reduced by preactivation of FV to FVa. (A) FV (2.5-20 nM) or (B) FVa (1-20 nM) was titrated into FV-deficient plasma in the absence (○) and presence (▼) of protamine (30 μg/mL). Thrombin generation was initiated with TF, phospholipid vesicles, and CaCl2 (see “Methods”), and ETP was calculated as before.