We would like to thank Lind et al1 for their study on thrombomodulin as a marker for bleeding complications during warfarin treatment. This longitudinal cohort study demonstrates that patients who have high levels of soluble thrombomodulin (sTM) and are receiving long-term vitamin K antagonist therapy appear to be at higher risk of clinically relevant and major bleeding complications. If validated, such a laboratory test would be of great importance and clinical utility in assessing the risk of long-term vitamin K antagonist therapy.
Nguyen CT, Chan GM, Su M. A Question of the Clinical Relevance of Determining Thrombomodulin Level While Receiving Anticoagulant Therapy. Arch Intern Med. 2009;169(21):2031. doi:10.1001/archinternmed.2009.422