Factor VIIa (FVIIa) is the triggering enzyme of the blood clotting cas
cade in hemostasis and thrombosis and may play an important role in hy
percoagulable states. Indeed, certain epidemiologic studies have found
elevated FVII coagulant activity to be an independent risk factor for
heart disease. However, FVII circulates as the inert zymogen (FVII),
the active enzyme (FVIIa), and possibly other forms as well, obscuring
the relationship between any specific form of this enzyme and risk of
thrombotic disease. New assay techniques based on soluble mutant tiss
ue factor now permit measurement of FVIIa without interference from th
e large excess of zymogen FVII in plasma. This in turn has enabled dir
ect examination of the role of plasma FVIIa in disease.