Endothelial cell injury
Impaired nitric oxide production Overproduction of reactive oxygen species
Increased von Willebrand factor and thrombomodulin Increased tissue factor production
Decreased antithrombin III production
Increased smooth muscle cell production
Increased monocyte adhesion to the vessel wall
Coagulation pathways
Impaired platelet survival time
Increased production of thromboxane A2 by platelets and decreased production of
prostacyclin
Increased activation of factors V, X, and XII
Inhibition of antithrombin III and factor C production Increased fibrinogen levels
Enhanced binding of lipoprotein (a) to fibrin
Oxidative stress
Overproduction of reactive oxygen species Decreased plasma antioxidant activities Increased lipid peroxidation
