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Plasminogen Activator Inhibitor 1 Promotes a Poor Prognosis in Sepsis-Induced Disseminated Intravascular Coagulation

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Abstract

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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Authors and 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

    Seiji Madoiwa, Tsukasa Ohmori, Jun Mimuro & Yoichi Sakata

  2. Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University, Tochigi, Japan

    Shin Nunomiya

  3. Research and Development Department, Mitsubishi Kagaku Iatron, Inc, Chiba, Japan

    Tomoko Ono & Yuichi Shintani

Authors
  1. Seiji Madoiwa
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  2. Shin Nunomiya
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  3. Tomoko Ono
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  4. Yuichi Shintani
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  5. Tsukasa Ohmori
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  6. Jun Mimuro
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  7. Yoichi Sakata
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Correspondence to Yoichi Sakata.

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Madoiwa, S., Nunomiya, S., Ono, T. et al. Plasminogen Activator Inhibitor 1 Promotes a Poor Prognosis in Sepsis-Induced Disseminated Intravascular Coagulation. Int J Hematol 84, 398–405 (2006). https://doi.org/10.1532/IJH97.05190

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  • DOI: https://doi.org/10.1532/IJH97.05190

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