Genetics of arterial prothrombotic risk states

Coronary artery disease is a leading cause of death worldwide and the large st killer of men and women in the United States. The pathophysiology of myo cardial infarction is multifactorial, and numerous physiologic systems conv erge to dictate the formation of the two fundamental lesions, thrombosis an d atherosclerosis. In this review we address genetic aspects of arterial th rombosis and the key thrombotic factors that have been associated with the increased risk for its development. Specifically, we consider components of coagulation, fibrinolysis, and platelet adhesive receptors, and we review the genetic epidemiology and in vitro laboratory data regarding their risk for the acute coronary syndromes. In combination with traditional risk fact or assessment, in the near future these inherited markers can be used to ma nage patients with vascular disease through a better utilization of invasiv e or expensive diagnostic testing, as well as pharmacologic intervention.