Diagnosis of disseminated intravascular coagulation by hemostatic molecular markers

In the present study, the positive rate of thrombin-antithrombin complex (TAT), plasmin-plasmin inhibitor complex (PPIC), soluble fibrin monomer (sFM), and D-dimer for the diagnosis of disseminated intravascular coagulation (DIG) was evaluated. The study comprised 307 patients with DIG, 123 with pre-DIG, and 121 with non-DIG. Plasma levels of TAT, PPIC, sFM, and D-dimer were significantly higher in DIG and pre-DIG patients than in non-DIG patients. In DIG patients, the positive rate of sFM was high and that of D-dimer was low; the positive rate of PPIC was higher in patients with hematopoietic malignancy than in those without this disease. In pre-DIG patients, the positive rate of all markers was low (<0.16), and the positive rate of PPIC was relatively high. In non-DIG patients, the positive rate of all hemostatic markers was low (<0.16), that of sFM being the lowest. Scoring the positive rate of TAT, PPIC, and sFM disclosed the following results: 72% of DIG patients had three or more points, 17.6% of pre-DIG patients had three or more points, and almost all (96.6%) non-DIG patients had two or less points. Scoring the positive rate of TAT, PPIC, and D-dimer disclosed the following results: 52.9% of DIG patients and 27.4% of pre-DIG patients had three or more points and almost all (96.7%) non-DIG patients had 2 or less points. These data suggest that the combination of TAT, PPIC, and sFM is useful for making the diagnosis of DIC.