Increased plasma levels of tissue factor pathway inhibitor-activated factor X complex in patients with disseminated intravascular coagulation.
Plasma levels of tissue factor pathway inhibitor (TFPI)-activated factor Xa (FXa) complex were measured in patients with disseminated intravascular coagulation (DIC), pre-DIC, and DIC. Plasma levels of plasmin-plasmin inhibitor complex (PPIC), D-dimer, and soluble fibrin monomer (SFM) were significantly higher in patients with DIC than in those with pre-DIC or non-DIC; the levels of these hemostatic markers were significantly higher in patients with pre-DIC than in those with non-DIC. Plasma levels of thrombin-antithrombin complex (TAT) were significantly higher in patients with DIC or pre-DIC than in those with non-DIC. Plasma levels of tissue factor (TF), total TFPI, free TFPI, and TFPI-Xa complex were significantly higher in patients with DIC than in those with non-DIC. Plasma levels of TFPI-Xa complex were significantly increased in patients with pre-DIC as compared to those with non-DIC; however, plasma free TFPI levels were significantly decreased in patients with pre-DIC as compared to those with non-DIC. These findings suggest that free TFPI might be consumed in the pre-DIC state, thereby confirming the activation of the extrinsic pathway. Plasma levels of TFPI-Xa complex were significantly correlated with TF, free TFPI, and total TFPI. Increased plasma TFPI-Xa complex levels might be useful for the diagnosis of DIC or pre-DIC, particularly that occurring by activation of the extrinsic pathway of blood coagulation.
Okugawa
Y
Y
Second Department of Internal Medicine, Mie University School of Medicine, Tsu-city, Mie-ken, Japan.
Wada
H
H
Noda
T
T
Sakakura
M
M
Nakasaki
T
T
Watanabe
R
R
Deguchi
H
H
Gabazza
E C
EC
Mori
Y
Y
Nishikawa
M
M
Deguchi
K
K
Nobori
T
T
Shiku
H
H
D000925:Anticoagulants / Q000378:metabolism; D004211:Disseminated Intravascular Coagulation / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D015951:Factor Xa / Q000378:metabolism*; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents / Q000378:metabolism; D006801:Humans; D008074:Lipoproteins / Q000378:metabolism*
D000925:Anticoagulants; D065427:Factor Xa Inhibitors; D005343:Fibrinolytic Agents; D008074:Lipoproteins; C051928:lipoprotein-associated coagulation inhibitor; D015951:Factor Xa