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[Study of hemostatic molecular marker]
Insights
Early diagnosis and treatment of disseminated intravascular coagulation (DIC) are crucial for better outcomes. Soluble fibrin monomer shows promise as a key diagnostic marker for DIC and related thrombotic disorders.
Area of Science:
- Hematology
- Internal Medicine
- Pathophysiology
Context:
- Thrombotic disorders, including disseminated intravascular coagulation (DIC), deep vein thrombosis, pulmonary embolism, myocardial infarction, and cerebral infarction, pose significant health risks.
- Effective management relies on early diagnosis and understanding of underlying hemostatic and vascular processes.
Purpose:
- To evaluate hemostatic molecular markers for diagnosing and predicting outcomes in thrombotic disorders.
- To identify the most effective markers for early detection and management of DIC and related conditions.
Summary:
- Treatment efficacy for DIC was significantly higher in the pre-DIC stage compared to established DIC, underscoring the importance of early intervention.
- Soluble fibrin monomer demonstrated high sensitivity and specificity for DIC diagnosis.
- Markers such as plasminogen activator inhibitor-1, activated protein C-protein C inhibitor complex, GMP-140, and thrombomodulin (TM) were evaluated for their diagnostic and prognostic value in various thrombotic events.
- High plasma TM levels correlated with poor outcomes, leading to the proposed concept of systemic vascular endothelium injuries syndrome.
Impact:
- The findings highlight the critical role of early diagnosis and treatment initiation in improving patient outcomes for DIC.
- Identified key molecular markers can enhance diagnostic accuracy and risk stratification for thrombotic disorders.
- The proposed systemic vascular endothelium injuries syndrome framework may guide novel therapeutic strategies focused on vascular endothelium protection.
Abstract:
We examined hemostatic molecular markers in various thrombotic disorders. The efficacy of treatment in relation to the disseminated intravascular coagulation (DIC) score when the treatment was begun showed that greater efficacy was achieved in Pre-DIC than in DIC patients. The outcome was poorer with increasing DIC score, suggesting that early treatment is important. The sensitivity in some of molecular markers was high for both DIC and Pre-DIC. Receiver operating characteristic analysis suggest that soluble fibrin monomer level could be the most useful marker for the diagnosis of DIC. In examination of these markers in deep vein thrombosis, pulmonary embolism, acute myocardial infarction, and cerebral infarction, plasminogen activator inhibitor-1 and activated protein C-protein C inhibitor complex were useful marker for the diagnosis. Increased plasma GMP-140 was suggested to be the activation of platelets. The patients with high levels of plasma thrombomodulin (TM) considered to be a marker of vascular endothelial injuries became poor outcome. We will term these patients with high TM as systemic vascular endothelium injuries syndrome, and treat those by protecting the vascular endothelium.