Evaluation of haemostatic molecular markers for diagnosis of disseminated intravascular coagulation in patients with infections.
Early treatment of disseminated intravascular coagulation (DIC) is recommended but global coagulation tests used in authorized DIC criteria are not sensitive for diagnosis of early-phase DIC. We examined the plasma levels of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor complex (PPIC) and D-dimer in patients with suspected DIC to determine the cutoff values for diagnosis of DIC. Plasma levels of D-dimer, TAT and PPIC were significantly elevated in patients with DIC and correlated with DIC score. The cutoff values were determined using the receiver operative curve analysis. The cutoff value represented the point at which the sensitivity curve crossed the specificity curve. The cutoff values of D-dimer, TAT and PPIC for DIC were 12.0 mug/ml, 11.0 ng/ml and 1.8 mug/ml, respectively. These values were moderately to highly sensitive for the diagnosis of DIC but not for poor outcome. The combination of D-dimer, TAT and PPIC showed high sensitivity and low specificity when one or more tests were positive, but showed low sensitivity and high specificity when all three tests were positive. We conclude that hemostatic molecular markers might be useful for the diagnosis of DIC and should be confirmed by several trials.
Asakura
Hidesaku
H
Department of Laboratory Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu-city, Mie 514-8507, Japan.
Wada
Hideo
H
Okamoto
Kohji
K
Iba
Toshiaki
T
Uchiyama
Toshimasa
T
Eguchi
Yutaka
Y
Kawasugi
Kazuo
K
Koga
Shin
S
Mayumi
Toshihiko
T
Koike
Kaoru
K
Gando
Satoshi
S
D000368:Aged; D000990:Antithrombin III / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D004211:Disseminated Intravascular Coagulation / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005341:Fibrinolysin / Q000032:analysis; D006487:Hemostasis; D006801:Humans; D007239:Infections / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000032:analysis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000979:alpha-2-Antiplasmin / Q000032:analysis
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D000979:alpha-2-Antiplasmin; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C037742:plasmin-plasmin inhibitor complex; D000990:Antithrombin III; D010447:Peptide Hydrolases; D005341:Fibrinolysin