The usefulness of antithrombin activity monitoring during antithrombin supplementation in patients with sepsis-associated disseminated intravascular coagulation. Issue 5 (May 2015)

• Record Type: Journal Article
• Authors: Iba, Toshiaki; Saitoh, Daizoh; Gando, Satoshi; Thachil, Jecko
• Is Part Of: Thrombosis research. Volume 135:Issue 5(2015)
• Page Start: 897
• Page End: 901
• Publication Date: 2015-05
• Subjects: Antithrombin III -- Disseminated intravascular coagulation -- Sepsis -- Anticoagulant agents -- Consumption coagulopathies; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2015.03.007
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Introduction: Recent studies have repeatedly reported the effectiveness of antithrombin (AT) supplementation for sepsis-associated disseminated intravascular coagulation (DIC). In this study, we intended to elucidate the usefulness of monitoring antithrombin activity during antithrombin supplementation. Methods: Data of 926 patients with sepsis-associated DIC who had been undergone AT substitution were retrospectively analyzed. All the patients had received 1500 IU/day of AT concentrate for three consecutive days. The patients' demographic characteristics, including the age, body weight, baseline DIC score and baseline AT activity, and treatment-related markers such as the change in DIC score and the change in the AT activity with treatment were analyzed in relation to the 28-day mortality. Results: Logistic regression analysis revealed a significant association of the patients' age, baseline AT activity, Δ AT activity, baseline DIC score and Δ DIC score to the patients' outcomes. The cutoff values of the AT activities for death calculated by the ROC curve analysis were 41.3% for the baseline AT activity, 72.9% for the post-treatment AT activity and 37.0% for Δ AT activity. The area under the ROC curve (AUC) showed discriminative powers for the baseline AT activity, post-treatment AT activity and Δ AT activity of 0.58, 0.69 and 0.66, respectively. Conclusions: Monitoring of the AT activity is useful to predict the patients' outcome. Furthermore, the measurement of baseline AT activity may help in determining the appropriate dose for AT supplementation. Highlights: Monitoring of AT activity is useful for the evaluation of AT treatment in septic DIC. Post-treatment AT activity of 72.9% indicates the better outcome of DIC patients. Baseline AT activity may help in determining the dose for AT supplementation.