Higher Thrombin-Antithrombin III Complex Levels May Indicate Severe Acute Pancreatitis

Abstract

Aim: Coagulation disorders may develop in association with severe acute pancreatitis (AP). Plasma thrombin-antithrombin III complex (TAT) levels are one of the principal markers of coagulation disorder. The purpose of this study was to evaluate TAT and other hemostatic parameters in patients with AP and to examine whether or not these parameters indicate the severity of AP. Method: Forty-six patients with AP (14 severe, 32 non-severe) and a 30-member healthy control group were recruited. The severity of AP was determined using the revised Atlanta classification. ELISA was used to measure patients’ plasma TAT levels. Results: The TAT levels of AP patients at presentation were higher than those of the control group (p = 0.005). The plasma TAT levels of patients with severe AP were also significantly higher than those of patients with non-severe AP (p = 0.05) and of the control group (p < 0.001). The general accuracy, sensitivity and specificity of TAT levels in predicting the severity of AP were 77.4, 77.8, and 77.3% respectively. Conclusion: The coagulation cascade was activated in the AP patients in our study, and this was shown to become more pronounced as severity of the disease increased. Plasma TAT levels at the time of presentation in patients with AP can be used as a marker for predicting the severity of the disease.

Pathogenesis and Therapy of Coagulation Disorders in Severe Acute Pancreatitis

“…In AP patients, the level of TAFI rises at the onset of the disease. 45 Patients with OF have significantly higher plasma levels of PAI-1, and non-survivors demonstrate more potent suppression of fibrinolysis than survivors. 24 , 52 The high levels of fibrinolytic inhibitors may be the stimulation of proinflammatory factors and hypoxia.…”

“… 7 This phenomenon could be ascribed to a combination of impaired synthesis because of the negative acute-phase response, degradation by elastase, and consumption because of thrombin generation. 30 , 45 ATIII deficiency can result in severe venous thromboembolism 46 and is positively correlated with the severity of DIC. 47 On the other hand, ATIII (1500 units/day for 3 days when baseline plasma ATIII activity ≤69%) alone does not improve the DIC score in patients with acute cholangitis.…”

Effects of Four-Week Rehabilitation Program on Hemostasis Disorders in Patients with Spinal Cord Injury

“…Its anticoagulant properties are involved only in the coagulation pathway initiated by TF [20,21]. TAT complex is an indicator of prothrombin to thrombin activation and is one of the principal markers of blood hypercoagulability [22].…”