Plasminogen: an important hemostatic parameter in septic patients.

Abstract

BACKGROUND:

Previously we observed in some but not all septic patients a low plasma concentration of plasminogen.

OBJECTIVES:

To investigate prospectively whether plasma levels of plasminogen or the ratio of plasminogen to alpha-2-antiplasmin have a prognostic value for survival from sepsis and to study the variation of other hemostatic parameters during septicemia.

PATIENTS:

The study population consisted of 45 consecutive patients with septicemia, 15 non-septic patients from the same intensive care unit and 30 healthy volunteers.

MEASUREMENTS AND MAIN RESULTS:

Plasminogen concentrations were significantly lower (p < 0.001) in plasma of septic patients (median 0,62 IU/ml range: 0.15-1,06) than in plasma of healthy controls (median 1.00 IU/ml, range: 0.75-1.10) or of non-septic intensive care patients (median 1.00 IU/ml, range: 0.82-1.08). Among the other parameters tested, plasminogen activator inhibitor (PAI-1) antigen concentration and PAI activity were similar in septic and non-septic intensive care patients, but higher than in healthy controls. Concentrations of elastase-alpha-1-protease inhibitor or of thrombin-antithrombin complexes were higher in septic patients than in non-septic intensive care patients or healthy controls. A degraded form of plasminogen of 38 kDa was detected by Western blot analysis in the plasma of septic patients, but not in plasma of non-septic intensive care patients or controls. Plasminogen alone or the ratio of plasminogen to antiplasmin were good markers for survival from septicemia. E.g. for plasminogen at a cut off of 0.65 IU/ml, sensitivity was 90.5% and specificity 66.7%, whereas for the ratio of plasminogen over antiplasmin at a cut off ratio of 0,65 IU/ml, sensitivity was 95.2% and specificity 70.8%.

CONCLUSION:

Plasminogen or the ratio of plasminogen to antiplasmin are sensitive markers for survival in patients with septicemia.

• Authors: C Duboscq, I Quintana, E Bassilotta, G E Bergonzelli, P Porterie, B Sassetti, A S Haedo, N Wainsztein, E K Kruithof, L Kordich
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 77 Issue 6 Pg. 1090-5 (Jun 1997) ISSN: 0340-6245 [Print] Germany
• PMID: 9241738 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• alpha-2-Antiplasmin
• Plasminogen

Topics

• Adult
• Aged
• Hemostasis
• Humans
• Middle Aged
• Plasminogen (analysis)
• Prognosis
• Prospective Studies
• Sepsis (blood, physiopathology)
• alpha-2-Antiplasmin (analysis)