Measures of Thrombosis and Fibrinolysis

With robust armamentaria against hypertension and hyperlipidemia, additional CHD risk reduction likely may have to target the thrombotic component of the atherothrombotic disease process. Consequently, the establishment of laboratory markers of thrombosis and fibrinolysis as predictors of CHD may lead to the development of drugs that target these markers specifically. The proof positive of the value of these markers will come when randomized controlled trials, which are designed to link outcomes with an intervention that reduces these risk factors, are successful. Clinical trialists will need to pay particular attention, however, to the laboratory methodology to develop consistent, reproducible results. Furthermore, because atherothrombosis is a multifactorial process and numerous moderate risk factors act in association, better predictability of the hemostatic tests probably would result from the design of more representative tests and the evaluation of multiple parameters that would lead to the definition of a risk score.