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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:e18.)
© 2006 American Heart Association, Inc.

Letters to the Editor

Letter to the Editor

Assessment of Hemostatic Risk Factors in Predicting Arterial Thrombotic Events

Christopher J. Boos; Gregory Y.H. Lip

Hemostasis, Thrombosis, and Vascular Biology Unit University Department of Medicine, City Hospital Birmingham, United Kingdom

An extract of the first 250 words of the full text is provided, because this article has no abstract.

To the Editor:

We read with interest the excellent article by Feinbloom and Bauer outlining several key hemostatic risk factors that may be predictive of arterial thrombotic events.¹ We do appreciate that there are a wide range of key hemostatic risk factors involved in atherothrombosis, but their article has little mention of the evolving interest into fibrin D-dimer as an index of thrombogenesis, as well as the many endothelial specific vascular markers that have been intimately related to hemostasis and thrombosis, and have been shown to predictive of future cardiovascular events.

For example, plasma von Willebrand factor (vWF) is already a well-established plasma marker of endothelial damage/dysfunction. vWF is important in mediating platelet aggregation, suggesting a possible contributory prothrombotic role. Our group has previously shown that raised levels of vWF are predictive of thrombosis-related vascular events, such as ischemic stroke among patients with atrial fibrillation,² and major adverse cardiac events (MACEs) among patients presenting with acute coronary syndrome (ACS).³ Another endothelial marker is soluble E-selectin (sE-sel), which is an endothelial-specific membrane-bound adhesion molecule that is normally not expressed by resting endothelial cells, so raised plasma levels indicate endothelial activation. Increased sE-sel levels have also been shown to be predictive of future arterial thrombotic events.^4,5

As a relatively new "marker" predictive of thrombotic events, immunologically defined CD146-bearing circulating endothelial cells (CECs) is rapidly gaining ground as a novel and specific endothelial marker. CECs are thought to represent mature endothelial cells or endothelial cell fragments that have detached (or have been . . . [Full Text of this Article]