Do Haemostasis Activation Markers that Predict Cardiovascular Disease Exist?

Recognition of the central role of thrombosis in the pathogenesis of cardiovascular disease has prompted growing interest in the association of haemostatic variables with cardiovascular disease. In investigating the predictive value of haemostasis markers, a promising type of measurement is that of the activation products of coagulation and fibrinolysis: prothrombin fragment 1+2 (F1+2), fibrinopeptide A (FPA), soluble fibrin,thrombin-antithrombin (TAT), plasmin-antiplasmin(PAP) complexes and D-dimer. D-dimer was most extensively studied and there is substantial evidence that D-dimer is a strong, consistent predictor of cardiovascular events in the general population and inpatients with cardiovascular disease. Data on other markers are considerably less abundant and more controversial. The prognostic value of these markers remains to be fully defined in future epidemiological and clinical studies.