Plasma Antigen Levels of Thrombin-Activatable Fibrinolysis Inhibitor in Patients with Systemic Sepsis and Relation to Disseminated Intravascular Coagulation
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- Category: Vol. 77, December 2009
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Plasma Antigen Levels of Thrombin-Activatable Fibrinolysis Inhibitor in Patients with Systemic Sepsis and Relation to Disseminated Intravascular Coagulation, GAMAL HAMED, AMAL RISK, NASHWA ABED, MAHMOUD MAHFOUZ and HASSAN EL-AASSAR
Abstract
Thrombin-activatable fibrinolysis inhibitor (TAFI) is a carboxypeptidase that downregulates fibrinolysis and might play some roles in the pathogenesis of sepsis and so dissem-inated intravascular coagulation (DIC). We prospectively examined the plasma TAFI antigen levels in patients with sepsis. Patients were subdivided into patients with sepsis., severe sepsis and septic shock and patients who developed DIC as a result of sepsis. The APACHE II and The Sepsis-related Organ Failure Assessment (SOFA) scores were con-currently calculated on patients with sepsis. Overall, there were 40 patients with sepsis and 16 normal controle persons. Their baseline characteristics were similar. There was increased TAFI antigen levels in all patients however no significant difference between patients with sepsis., severe sepsis and septic shock regarding their TAFI antigen levels [median/ interquartile range (IQR) 205/35.3, 234.8/50.3, and 221.6+ 49.5nmol/l, respectively, p=0.543]. On regression analysis, TAFI antigen levels were correlated with various coagulation test results. APACHE II and SOFA scores were statistically significant (median/IQR 17.8/1.97, 19/1.9, and 21.3/203, respectively, p=0.684), for APACHE II (median/IQR 7.5/1.6, 10±2 and 7.4±1.94 respectively p=0.541). Our result indicated that plasma TAFI antigen levels did not vary significantly between patients with or without DIC. Further, they had correlation with the severity of organ injury in patients with sepsis. The TAFI activity in plasma was significantly high in patients with sepsis and in those with organ failure, suggesting that TAFI may play an important role in the mechanism of organ failure in sepsis and in DIC-associated sepsis. In brief, TAFI may play an important role in the pathogenesis of sepsis, DIC and organ failure.