Markers of hypercoagulation in cardiovascular disease in the general population

Despite global efforts, cardiovascular diseases, such as heart attack or stroke, are the leading cause of mortality and morbidity worldwide. More than ever, there is a medical and economical need for a different approach in managing prevention of cardiovascular disease. In this context, there is a large interest in novel biomarkers. This dissertation explores certain coagulation assays in relation to cardiovascular disease and cardiovascular and total mortality. The goal is to improve the individual risk assessment for cardiovascular disease. The studies show that the group of individuals with elevated values of certain components of coagulation (thrombin generation lag time, TFPI) is associated with higher mortality (both from cardiovascular disease and other causes). In addition, it shows that the group of individuals with lower levels of another coagulation protein (von Willebrand factor) is associated with a less likelihood to develop cardiovascular disease. These studies give basis to follow-up studies, for developing preventive treatment to lower the mentioned coagulation, or follow-up studies to develop risk assessment scores for preventive treatment for cardiovascular disease based on these tests.