title: Activated thrombin-activatable fibrinolysis inhibitor (TAFIa) levels are decreased in patients with trauma-induced coagulopathy.
abstract: BACKGROUND
  The thrombin-activatable fibrinolysis inhibitor (TAFI) is a potent inhibitor of fibrinolysis. However, the time course of TAFI and its activated form (TAFIa) following trauma, in particular in patients suffering trauma-induced coagulopathy, has been poorly examined.
  
  
  METHODS
  A total of 26 severely injured trauma patients were prospectively enrolled. TAFI and TAFIa levels were measured upon arrival and through hospital days one to 10. Trauma-induced coagulopathy was defined as elevated international normalized ratio (INR), and/or prolonged activated partial thromboplastin time (aPTT) and/or thrombocytopenia within one day of admission.
  
  
  RESULTS
  TAFIa and TAFI levels showed the largest decrease on days one and two, respectively, with a progressive increase thereafter. Overall, 11 patients developed coagulopathy. No statistically significant differences were found for TAFI levels between the two groups. For TAFIa, however, coagulopathic patients experienced significantly lower levels on admission and on days six to eight (all p<0.05). Statistically significant correlations were found between TAFIa level on admission and the amount of packed red blood cells (p=0.011; Spearman's correlation coefficient=-0.5) and fresh frozen plasma (p=0.044; Spearman's correlation coefficient=-0.405) transfused within the initial 24hours.
  
  
  CONCLUSIONS
  Depletion of TAFIa may contribute to the development of trauma-induced coagulopathy.
authors.affiliation: Department of Trauma, Hand and Reconstructive Surgery, Goethe University Frankfurt am Main, Frankfurt, Germany. tom.lustenberg@gmail.com
authors.forename: T
authors.initials: T
authors.lastname: Lustenberger
authors.forename: B
authors.initials: B
authors.lastname: Relja
authors.forename: B
authors.initials: B
authors.lastname: Puttkammer
authors.forename: E C
authors.initials: EC
authors.lastname: Gabazza
authors.forename: E
authors.initials: E
authors.lastname: Geiger
authors.forename: Y
authors.initials: Y
authors.lastname: Takei
authors.forename: J
authors.initials: J
authors.lastname: Morser
authors.forename: I
authors.initials: I
authors.lastname: Marzi
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D025901:Carboxypeptidase B2 / Q000097:blood*; D015536:Down-Regulation; D017707:Erythrocyte Transfusion; D005260:Female; D006760:Hospitalization; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011446:Prospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000209:etiology; D013997:Time Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000097:blood / Q000150:complications* / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D025901:Carboxypeptidase B2