New markers for in vivo coagulation.

Advances in our understanding of the biochemistry of the hemostatic mechanism have led to the development of sensitive methods for measuring peptides, enzyme-inhibitor complexes, or enzymes that are liberated with the activation of the coagulation system in vivo. Studies employing these markers indicate that a biochemical imbalance between procoagulant and anticoagulant mechanisms can be detected in the blood of humans prior to the appearance of thrombotic phenomena. Properly designed prospective studies will be required to determine whether these assay techniques will enable us to identify individuals who are entering a clinically relevant hypercoagulable state and intervene with appropriate therapy prior to the onset of overt thrombotic disease.