SERPINE1 and obesity due to melanocortin 4 receptor deficiency: The risk for thrombotic cardiovascular events is even further enhanced by the hypercoagulable state that is associated with obesity, as obese subjects have increased plasma levels of procoagulant factor (F) VII, VIII, XII and fibrinogen, while fibrinolysis is decreased as reflected by increased levels of plasminogen activator inhibitor-1 (PAI-1) [1–3].