Evaluation the combined diagnostic value of TAT, PIC, tPAIC, and sTM in disseminated intravascular coagulation: A multi-center prospective observational study

Mei, Heng; Jiang, Ying; Huang, Ruibin; Su, Lei; Hou, Ming; Wang, Xuefeng; Deng, Jun; Hu, Yu

doi:10.1016/j.thromres.2018.11.010

Cited by 48 publications

(59 citation statements)

References 32 publications

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“…The levels of the complex reflect thrombin generation and it is considered a sensitive marker for the activation of intravascular coagulation [45,46]. To date, increased thrombin levels imply activation of the blood coagulation cascade and have a clinically significant value for the diagnosis and risk assessment of thromboembolic events [47,48]. In vivo data, obtained following i.v.…”

Section: Discussionmentioning

confidence: 99%

Role of Autophagy in Von Willebrand Factor Secretion by Endothelial Cells and in the In Vivo Thrombin-Antithrombin Complex Formation Promoted by the HIV-1 Matrix Protein p17

Bugatti

Marsico

Mazzuca

et al. 2020

IJMS

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Although the advent of combined antiretroviral therapy has substantially improved the survival of HIV-1-infected individuals, non-AIDS-related diseases are becoming increasingly prevalent in HIV-1-infected patients. Persistent abnormalities in coagulation appear to contribute to excess risk for a broad spectrum of non-AIDS defining complications. Alterations in coagulation biology in the context of HIV infection seem to be largely a consequence of a chronically inflammatory microenvironment leading to endothelial cell (EC) dysfunction. A possible direct role of HIV-1 proteins in sustaining EC dysfunction has been postulated but not yet investigated. The HIV-1 matrix protein p17 (p17) is secreted from HIV-1-infected cells and is known to sustain inflammatory processes by activating ECs. The aim of this study was to investigate the possibility that p17-driven stimulation of human ECs is associated with increased production of critical coagulation factors. Here we show the involvement of autophagy in the p17-induced accumulation and secretion of von Willebrand factor (vWF) by ECs. In vivo experiments confirmed the capability of p17 to exert a potent pro-coagulant activity soon after its intravenous administration.

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Section: Discussionmentioning

confidence: 99%

Role of Autophagy in Von Willebrand Factor Secretion by Endothelial Cells and in the In Vivo Thrombin-Antithrombin Complex Formation Promoted by the HIV-1 Matrix Protein p17

Bugatti

Marsico

Mazzuca

et al. 2020

IJMS

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“…Coagulation function should be monitored during anticoagulation treatment to assess anticoagulation efficacy and the risk of bleeding. If there is active bleeding (such as intracranial hemorrhage and gastrointestinal bleeding), evaluation of the appropriate timing for anticoagulant therapy should be conducted after controlling the bleeding [92].…”

Section: Anticoagulant Therapymentioning

confidence: 99%

Expert consensus on the diagnosis and treatment of heat stroke in China

et al. 2020

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Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. In 2015, the People's Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years, the 2015 consensus no longer meet the requirements for HS prevention and treatment. It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China's national conditions. This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.

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“…The process of thrombosis is a multifactor continuous complication related to the coagulation system, fibrinolysis system, and endothelial system [16,17]. At present, the routine laboratory parameters fortesting coagulation, such as prothrombin time,activated partial thromboplastin time,thrombin time,fibrinogen,D-dimer,FDP,and coagulation factor have covered the coagulation and fibrinolysis systems;however, all these parameters enable passive detection and involve late screening after thrombosis, and are not sensitive to the pre-thrombotic state and pre-disseminated intravascular coagulation(pre-DIC).…”

Section: Discussionmentioning

confidence: 99%

“…Damage to the vascular endothelium in patients with malignant tumors can increase the level of TM [23].t-PAIC not only reflects the abnormality of fibrinolysis system but is also related to endothelial damage [24]. TM and t-PAIC are also useful markers for predicting organ failure and clinical prognosis in patients with DIC and thrombotic diseases [25][26][27]17].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the results of ROC analysis showed that the six markers had certain value in the diagnosis of VTE in patients with malignant tumors, of which TAT had the highest diagnostic value.The best cutoff value of TAT was 30.76 μg/L, the AUC was 0.875, and the sensitivity and specificity were higher than those of D-dimer and FDP.In the diagnosis of VTE, we found that although the application of a single marker has certain clinical significance, a combination of four or six markers can improve the AUC, sensitivity, and specificity. The study by Mei et al [17] reported that TAT, PIC,t-PAIC, and TM had good diagnostic and prognostic value in the diagnosis of DIC in different basic diseases, and that a combination of the four markers showed better efficacy than that shown by a single marker alone.Therefore,TAT, PIC, TM, and t-PAIC combined with D-dimer and FDP can be used as sensitive markers for the diagnosis of VTE in patients with malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic and prognostic value of TAT,PIC,TM, and t-PAIC in malignant tumor patients with venous thrombosis

Zhou

Zhang

Zheng

et al. 2020

Preprint

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Background: Venous thromboembolism (VTE) is an important complication in patients with malignant tumors.Its exact diagnosis and treatment are still lacking.We used a high-sensitive chemiluminescence method to detect thrombin–antithrombin III complex (TAT),plasmin-α2-plasmininhibitor complex (PIC), thrombomodulin (TM),and tissue plasminogen activator–inhibitor complex(t-PAIC) in combination with D-dimer and fibrin degradation product (FDP) to analyze their diagnostic and prognostic value in patients with malignant tumors. Methods: In total, 870 patients with confirmed malignant tumors were included, 82 of whom had suspected VTE;200 healthy individuals were classified as the control group. The TAT, PIC,TM, and t-PAIC were detected using Sysmex HISCL5000 automated analyzers, whereas FDP and D-dimer were detected using Sysmex CS5100 coagulation analyzer.Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency.Survival probabilities were determined using Kaplan–Meier analysis, and multivariate analyses were performed using a Cox regression model. Results: Compared with healthy controls,patients with malignant tumors showed significantly elevated TAT,PIC,TM,t-PAIC,D-dimer, and FDP. Similarly, compared with patients in the non-thrombosis group, those in the thrombosis group showed significantly elevated levels of the above mentioned markers. Logistic regression analysis showed that TAT, PIC, TM, t-PAIC, D-Dimer, and FDP were all associated with VTE.ROC analysis showed that “TAT+PIC+TM+t-PAIC+D-dimer+FDP”showed the highest sensitivity and specificity.Patients with elevated TAT,PIC,TM, and t-PAIC had a significantly shorter survival.Multivariate Cox survival analysis showed that TM and t-PAIC were significantly associated with poor prognosis.In addition, the incidence of VTE was significantly lower in patients with malignant tumors who were treated with low-molecular-weight heparin (LMWH), and their survival period was significantly longer than that of patients with malignant tumors who were not treated with LMWH. Conclusion: TAT, PIC, TM, and t-PAIC combined with D-dimer and FDP were better than the application of a single marker in the diagnosis of VTE in patients with malignant tumors.TAT and PIC can be used as sensitive markers in the diagnosis of VTE but not as prognostic markers. TM and t-PAIC might be independent prognostic indicators in patients with malignant tumors, regardless of the state of thrombus.

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Evaluation the combined diagnostic value of TAT, PIC, tPAIC, and sTM in disseminated intravascular coagulation: A multi-center prospective observational study

Cited by 48 publications

References 32 publications

Role of Autophagy in Von Willebrand Factor Secretion by Endothelial Cells and in the In Vivo Thrombin-Antithrombin Complex Formation Promoted by the HIV-1 Matrix Protein p17

Role of Autophagy in Von Willebrand Factor Secretion by Endothelial Cells and in the In Vivo Thrombin-Antithrombin Complex Formation Promoted by the HIV-1 Matrix Protein p17

Expert consensus on the diagnosis and treatment of heat stroke in China

Diagnostic and prognostic value of TAT,PIC,TM, and t-PAIC in malignant tumor patients with venous thrombosis

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