Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis

Nuri Lee, Ji Eun Kim, Ja Yoon Gu, Hyun Ju Yoo, Inho Kim, Sung Soo Yoon, Seonyang Park, Kyou Sup Han, Hyun Kyung Kim

Research output: Contribution to journalArticle

Abstract

Disseminated intravascular coagulation (DIC) is characterized by consumption of coagulation factors and anticoagulants. Thrombin generation assay (TGA) gives useful information about global hemostatic status. We developed a new TGA system that anticoagulant addition can deplete thrombin generation in plasma, which may reflect defective anticoagulant system in DIC. TGAs were measured on the calibrated automated thrombogram with and without thrombomodulin or protein Z in 152 patients who were suspected of having DIC, yielding four parameters including lag time, endogenous thrombin potential, peak thrombin and time-to-peak in each experiment. Nonsurvivors showed significantly prolonged lag time and time-to-peak in TGA-protein Z system, which was performed with added protein Z. In multivariate Cox regression analysis, lag time and time-to-peak in TGA system were significant independent prognostic factors. In TGA-protein Z system, lag time and time-to-peak were revealed as independent prognostic factors of DIC. Protein Z addition could potentiate its anticoagulant effect in DIC with poor prognosis, suggesting the presence of defective protein Z system. The prolonged lag time and time-to-peak in both TGA and TGA-protein Z systems are expected to be used as independent prognostic factors of DIC.

Original languageEnglish
Pages (from-to)84-89
Number of pages6
JournalBlood Coagulation and Fibrinolysis
Volume27
Issue number1
DOIs
StatePublished - 1 Jan 2016

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Disseminated Intravascular Coagulation
Thrombin
Anticoagulants
Thrombin Time
Thrombomodulin
Blood Coagulation Factors
plasma protein Z
Hemostatics
Regression Analysis

Keywords

  • Disseminated intravascular coagulation
  • Prognosis
  • Protein Z
  • Thrombin generation assay

Cite this

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title = "Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis",
abstract = "Disseminated intravascular coagulation (DIC) is characterized by consumption of coagulation factors and anticoagulants. Thrombin generation assay (TGA) gives useful information about global hemostatic status. We developed a new TGA system that anticoagulant addition can deplete thrombin generation in plasma, which may reflect defective anticoagulant system in DIC. TGAs were measured on the calibrated automated thrombogram with and without thrombomodulin or protein Z in 152 patients who were suspected of having DIC, yielding four parameters including lag time, endogenous thrombin potential, peak thrombin and time-to-peak in each experiment. Nonsurvivors showed significantly prolonged lag time and time-to-peak in TGA-protein Z system, which was performed with added protein Z. In multivariate Cox regression analysis, lag time and time-to-peak in TGA system were significant independent prognostic factors. In TGA-protein Z system, lag time and time-to-peak were revealed as independent prognostic factors of DIC. Protein Z addition could potentiate its anticoagulant effect in DIC with poor prognosis, suggesting the presence of defective protein Z system. The prolonged lag time and time-to-peak in both TGA and TGA-protein Z systems are expected to be used as independent prognostic factors of DIC.",
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Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis. / Lee, Nuri; Kim, Ji Eun; Gu, Ja Yoon; Yoo, Hyun Ju; Kim, Inho; Yoon, Sung Soo; Park, Seonyang; Han, Kyou Sup; Kim, Hyun Kyung.

In: Blood Coagulation and Fibrinolysis, Vol. 27, No. 1, 01.01.2016, p. 84-89.

Research output: Contribution to journalArticle

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T1 - Protein Z efficiently depletes thrombin generation in disseminated intravascular coagulation with poor prognosis

AU - Lee, Nuri

AU - Kim, Ji Eun

AU - Gu, Ja Yoon

AU - Yoo, Hyun Ju

AU - Kim, Inho

AU - Yoon, Sung Soo

AU - Park, Seonyang

AU - Han, Kyou Sup

AU - Kim, Hyun Kyung

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