Plasminogen activator inhibitor 1: a new prognostic marker in septic shock.
The prognostic value of plasminogen activator inhibitor type 1 (PAI-1) in septic shock was investigated in 52 patients with septic shock. The patients had significantly elevated serum PAI-1 levels with respect to the control group (p = 0.002). In patients not having a rapidly fatal underlying disease, PAI-1 was significantly higher in patients dying within a week after onset of shock than in survivors (median PAI-1: 900 and 307 ng/ml, respectively; p = 0.001). The analysis of the distribution of PAI-1 levels permitted retrospectively to determine a threshold level of PAI-1 which had prognostic significance. Mortality was 71% in patients with serum PAI-1 above 550 ng/ml, whereas only two patients (6%) having a PAI-1 below 550 ng/ml died within a week. Thus, in patients with septic shock, PAI-1 appears to have a strong predictive value as to mortality. This early marker may help the clinician in identifying a subgroup of patients particularly at risk.
Pralong
G
G
Hematology Laboratory, University Hospital, Lausanne, Switzerland.
Calandra
T
T
Glauser
M P
MP
Schellekens
J
J
Verhoef
J
J
Bachmann
F
F
Kruithof
E K
EK
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000037:antagonists & inhibitors*; D015849:Plasminogen Inactivators / Q000097:blood*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality
D015415:Biomarkers; D015849:Plasminogen Inactivators; D010960:Plasminogen Activators