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 (PPI...
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Published in | Thrombosis and haemostasis Vol. 95; no. 2; p. 282 |
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Main Authors | , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Germany
01.02.2006
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Abstract | 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. |
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AbstractList | 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. |
Author | Kawasugi, Kazuo Uchiyama, Toshimasa Iba, Toshiaki Mayumi, Toshihiko Koike, Kaoru Koga, Shin Asakura, Hidesaku Wada, Hideo Eguchi, Yutaka Okamoto, Kohji Gando, Satoshi |
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SubjectTerms | Aged alpha-2-Antiplasmin - analysis Antithrombin III - analysis Biomarkers - blood Disseminated Intravascular Coagulation - complications Disseminated Intravascular Coagulation - diagnosis Female Fibrin Fibrinogen Degradation Products - analysis Fibrinolysin - analysis Hemostasis Humans Infection - complications Male Middle Aged Peptide Hydrolases - analysis Retrospective Studies ROC Curve Sensitivity and Specificity |
Title | Evaluation of haemostatic molecular markers for diagnosis of disseminated intravascular coagulation in patients with infections |
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