Plasminogen Activator Inhibitor 1 Promotes a Poor Prognosis in Sepsis-Induced Disseminated Intravascular Coagulation
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Sepsis-induced disseminated intravascular coagulation (DIC) is a serious condition because it is closely linked to the development of multiple organ dysfunctions.We compared molecular fibrinolysis markers for 117 patients with sepsis-induced DIC and 1627 patients with nonseptic DIC. Levels of fibrinogen and fibrin degradation products and D-dimer were significantly lower in sepsis-induced DIC cases than in nonseptic DIC cases. In septic DIC cases, plasma plasminogen activator inhibitor 1 (PAI-1) levels were significantly higher than in nonseptic DIC cases. D-dimer levels were negatively correlated with plasma PAI-1 levels in septic DIC cases. Multiple Organ Dysfunction Scores were significantly higher in septic DIC patients with PAI-1 levels >90 ng/mL than in the group with PAI-1 levels <30 ng/mL. The Kaplan-Meier survival functions until 28 days after DIC diagnosis were significantly lower in the group with PAI-1 levels >90 ng/mL than in the other groups. In a multivariate analysis, plasma PAI-1 levels at DIC diagnosis were an independent risk factor for mortality in sepsis-induced DIC (hazard ratio, 1.012; P = .008). These data suggest that plasma PAI-1 plays an important role in sustaining DIC in septic DIC cases and contributes to multiple organ failure and decreased survival in such patients.
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- Plasminogen Activator Inhibitor 1 Promotes a Poor Prognosis in Sepsis-Induced Disseminated Intravascular Coagulation
International Journal of Hematology
Volume 84, Issue 5 , pp 398-405
- Cover Date
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- Online ISSN
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- Plasminogen activator inhibitor 1
- Disseminated intravascular coagulation
- Multiple organ failure Prognosis
- Industry Sectors
- Author Affiliations
- 1. Research Division of Cell and Molecular Medicine, Center for Molecular Medicine, School of Medicine, Jichi Medical University, 3311-1, Yakushi-ji, Shimotsuke, 329-0498, Tochigi, Japan
- 2. Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University, Tochigi, Japan
- 3. Research and Development Department, Mitsubishi Kagaku Iatron, Inc, Chiba, Japan