Prognostic values of the factor Xa-activated clotting time and endogenous thrombin potential in patients suspected of having disseminated intravascular coagulation

Seo, Ji-Weon; Kim, Hyun Kyung; Kim, Jieun; Park, Wan Beom; Cho, Han‐Ik

doi:10.1016/j.thromres.2008.03.017

Cited by 31 publications

(24 citation statements)

References 26 publications

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“…29 However, several groups have reported that patients with sepsis present no signs of systemic hypercoagulability when evaluated with the thrombin generation assay, even in the early stages of sepsis. [30][31][32][33][34] It should be noted that thrombin generation in previous studies was analyzed in PPP triggered with relipidated tissue factor (ie, via the extrinsic pathway) rather than with CaCl 2 as was done in the present study. Thus, previous studies have overlooked the importance Figure 6.…”

Section: Discussionmentioning

confidence: 97%

Neutrophil Extracellular Traps Promote Thrombin Generation Through Platelet-Dependent and Platelet-Independent Mechanisms

Gould

Swystun

et al. 2014

ATVB

401

374

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Objective— Activation of neutrophils by microbial or inflammatory stimuli results in the release of neutrophil extracellular traps (NETs) that are composed of DNA, histones, and antimicrobial proteins. In purified systems, cell-free DNA (CFDNA) activates the intrinsic pathway of coagulation, whereas histones promote thrombin generation through platelet-dependent mechanisms. However, the overall procoagulant effects of CFDNA/histone complexes as part of intact NETs are unknown. In this study, we examined the procoagulant potential of intact NETs released from activated neutrophils. We also determined the relative contribution of CFDNA and histones to thrombin generation in plasmas from patients with sepsis. Approach and Results— NETs released from phorbyl myristate–activated neutrophils enhance thrombin generation in platelet-poor plasma. This effect was DNA dependent (confirmed by DNase treatment) and occurred via the intrinsic pathway of coagulation (confirmed with coagulation factor XII– and coagulation factor XI–depleted plasma). In platelet-rich plasma treated with corn trypsin inhibitor, addition of phorbyl myristate–activated neutrophils increased thrombin generation and shortened the lag time in a toll-like receptor-2– and toll-like receptor-4–dependent mechanism. Addition of DNase further augmented thrombin generation, suggesting that dismantling of the NET scaffold increases histone-mediated, platelet-dependent thrombin generation. In platelet-poor plasma samples from patients with sepsis, we found a positive correlation between endogenous CFDNA and thrombin generation, and addition of DNase attenuated thrombin generation. Conclusions— These studies examine the procoagulant activities of CFDNA and histones in the context of NETs. Our studies also implicate a role for the intrinsic pathway of coagulation in sepsis pathogenesis.

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Section: Discussionmentioning

confidence: 97%

Neutrophil Extracellular Traps Promote Thrombin Generation Through Platelet-Dependent and Platelet-Independent Mechanisms

Gould

Swystun

et al. 2014

ATVB

401

374

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“…Moreover, Joop and coworkers used FCM and suggested that the PDMP level is simply a reflection of the platelet count 16) . Therefore, according to the findings of several studies, the PDMP/Plts ratio should be a constant value, regardless of the presence of thrombopenia [40][41][42] . In our study using ELISA, the thrombopenia group has significantly elevated PDMP values, and there was a weak but significant negative correlation between the max PDMP value and the nadir platelet count.…”

Section: Conflicts Of Interestmentioning

confidence: 99%

Association of the Plasma Platelet-Derived Microparticles to Platelet Count Ratio with Hospital Mortality and Disseminated Intravascular Coagulopathy in Critically Ill Patients

Ohuchi

Fujino

Kishimoto

et al. 2015

J Atheroscler Thromb

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Aim:The role of platelet-derived microparticles (PDMPs) in the crosstalk between coagulopathy and inflammation in critically ill patients remains unclear. The aim of this cohort observational study was to investigate the associations between the PDMP levels and hospital mortality or disseminated intravascular coagulopathy (DIC). Methods: This study included 119 patients who were admitted to the ICU. The PDMP levels were measured using an enzyme-linked immunosorbent assay three times a week, for a total of 372 samples. We calculated the maximum (max) PDMP value, max PDMP/platelet (PDMP/Plts) ratio (converted to the PDMP levels per 10 4 platelets) and nadir platelet count during the ICU stay. Baseline patient data and scores, including the Japanese Association for Acute Medicine (JAAM) DIC score, were collected, and potential predictors were analyzed for possible associations with hospital mortality. Results: The max PDMP/Plts ratio was significantly different comparing the survivors (n 98: median, 2.54) and non-survivors (n 21: median 17.59; p 0.001). There was a weak but statistically significant negative correlation between the max PDMP level and nadir platelet count (r 0.332, p 0.001). The max PDMP level and max PDMP/Plts ratio were higher in the DIC group (81.48 and 9.27, respectively) than in the non-DIC group (34.88 and 2.35, p 0.001 and p 0.001, respectively). The max PDMP/Plts ratio was the only variable found to be independently associated with hospital mortality according to a multivariate logistic regression analysis. Conclusions: PDMPs are involved in the development of DIC but are not related to hospital mortality. There is a good association between the PDMP/Plts ratio and hospital mortality and/or DIC in critically ill patients.

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“…In a population of septic patients suspected of DIC, Ji Wean Seo observed an association between low ETP alone and Peak and longer LT and DIC [25]. Some of these studies also showed an association between TGT abnormalities (notably low ETP and Peak, longer Lag Time) and survival [23,25]. The few differences between these studies and the present study may be linked to case-mix differences, notably with regard to the mortality rate in septic patients (either overall or in those without DIC) being much lower in the above studies as well as differences in the TGT measurement protocol (see below).…”

Section: Discussionmentioning

confidence: 93%

“…Collins and Petros both found, without differentiating patients with or without DIC, a significant decrease in Peak and an increase in Lag Time and Time to Peak without any significant modification of ETP [23,24]. In a population of septic patients suspected of DIC, Ji Wean Seo observed an association between low ETP alone and Peak and longer LT and DIC [25]. Some of these studies also showed an association between TGT abnormalities (notably low ETP and Peak, longer Lag Time) and survival [23,25].…”

Section: Discussionmentioning

confidence: 95%

Ex vivo thrombin generation patterns in septic patients with and without disseminated intravascular coagulation

Carlier¹,

Hunault²,

Lerolle³

et al. 2015

Thrombosis Research

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Prognostic values of the factor Xa-activated clotting time and endogenous thrombin potential in patients suspected of having disseminated intravascular coagulation

Cited by 31 publications

References 26 publications

Neutrophil Extracellular Traps Promote Thrombin Generation Through Platelet-Dependent and Platelet-Independent Mechanisms

Neutrophil Extracellular Traps Promote Thrombin Generation Through Platelet-Dependent and Platelet-Independent Mechanisms

Association of the Plasma Platelet-Derived Microparticles to Platelet Count Ratio with Hospital Mortality and Disseminated Intravascular Coagulopathy in Critically Ill Patients

Ex vivo thrombin generation patterns in septic patients with and without disseminated intravascular coagulation

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