Thrombin and protease-activated receptor 1 (PAR1) activation antagonists were prepared based upon the peptide RPPGF, the angiotensin-converting enzyme breakdown product of bradykinin. A library of 72 peptides consisting of D and/or synthetic amino acids was designed with various substitutions in positions 1 to 5 in Arg-Pro-Pro-Gly-Phe (RPPGF). Two compounds, rOicPGF (TH146) and AK2K-4(rOicPGF) (MAP4-TH146), were characterized further. TH146 or MAP4-TH146 completely inhibits threshold ␥-thrombin-induced platelet aggregation at a concentration of 142 Ϯ 0.05 or 19 Ϯ 0.06 M, respectively. TH146 completely inhibits threshold ␣-thrombin-induced washed platelet aggregation at 444 Ϯ 0.04 M. TH146 or MAP4-TH146 blocks 2 nM ␣-thrombin-induced fibroblast calcium mobilization with an IC 50 value of 110 or 18 M, respectively. Furthermore, significant prolongation of the activated partial thromboplastin time, prothrombin time, or thrombin clotting time occurs at 31, 62, or 7.8 M TH146 and 0.4, 6.25, or 1.56 M MAP4-TH146, respectively. TH146 and MAP4-TH146 inhibit both ␣-thrombin with a K i value of 97 and 49 M, respectively, and factor VIIa with a K i value of 44 and 5 M, respectively. Both TH146 and MAP4-TH146 specifically bind to the exodomain of recombinant PAR1. MAP4-TH146 (200 M) completely blocks thrombocytin, a PAR1-activating snake venom protease, without inhibiting the enzyme's active site. TH146 inhibits ␥-thrombin-induced aggregation of mouse platelets, prolongs mouse bleeding times, and delays the time to mouse carotid artery thrombosis. TH146 and MAP4-TH146 inhibit human and mouse platelet aggregation and mouse thrombosis. Analogs of RPPGF are model compounds to develop PAR1 activation antagonists as well as direct inhibitors to thrombin and factor VIIa.Investigations from a number of laboratories indicate that platelet receptors for thrombin are antiplatelet targets. Hanson and Harker (1988) showed that treatment of baboons with Phe-Pro-Arg-chloromethylketone, a potent direct acting thrombin inhibitor, prolongs the bleeding time. More recently, knockout mice of protease-activated receptor (PAR) 3 or 4, mouse platelet thrombin receptors, independently prolong bleeding times and are protected against ferric chlorideinduced thrombosis (Weiss et al., 2002). Cook et al. (1995) showed that an IgG raised to a peptide of the hirudin-anionic binding region on the exosite of human PAR1 reduces or abolishes cyclic flow variations in the carotid artery of monkeys. A nonpeptide mimetic (RWJ-58259) directed to the cleaved PAR1 activation site after a 3 mg/kg intravenous bolus followed by a constant infusion of 0.123 mg/kg/min significantly prolongs the time to carotid artery thrombosis in monkeys (Derian et al., 2003). Furthermore, another nonpeptide mimetic at 1 mg/kg directed to the SFLLRN activation site on PAR1 delays the time to guinea pig carotid artery thrombosis (Kato et al., 2003). These combined studies indicate that inhibition of thrombin, thrombin binding to PAR1, and/or PAR1 activation prolongs the bleed...