LETTER TO THE EDITOR: Circulating endothelial cells: A new predictor of myocardial infarction

Madam, People from the Indo-Asian region are highly susceptible to coronary artery disease (CAD), and therefore CAD has now become the leading cause of mortality in the Indo-Pakistan subcontinent. The disease is characterized by the formation of atherosclerotic plaques, which ultimately ulcerate or break. This leads to clot formation, diminishes blood flow to myocardial cells and thus induces myocardial infarction. The inflammatory process within the arterial wall denudes the endothelium and increases the number of circulating endothelial cells (CECs) in the bloodstream. CECs have now become an important biomarker to monitor arterial plaque disruption, and therefore a potential diagnostic tool to identify patients at the greatest risk of myocardial infarction. At present, no test exists that could accurately predict the risk of heart attack since all of the tests currently available for CAD detect the underlying high risk conditions, rather than an impending arterial plaque rupture.