Increased truncated form of plasma tissue factor pathway inhibitor levels in patients with disseminated intravascular coagulation

To evaluate that the relationship between the truncated form of tissue factor pathway inhibitor (TFPI) and the stage of disseminated intravascular coagulation (DIC), we measured the plasma levels of tissue factor (TF) antigen and the intact and truncated forms of TFPI antigens in 41 patients with DIG, 12 with pre-DIG, and 20 with non-DIG. The plasma TF and total TFPI antigen levels were significantly higher in patients with DIG than in non-DIG patients. Plasma levels of intact TFPI antigen in the pre-DIG groups were significantly lower than in the non-DIG and DIG groups. The truncated form of TFPI antigen levels in DIG patients were significantly increased compared with those in non-DIG and pre-DIG patients. The fact that the intact form of TFPI was decreased in pre-DIG patients compared with that in non-DIG patients, suggests that it is consumed in the pre-DIG state and that hypercoagulability occurs in pre-DIG patients. The increased level of the truncated form of TFPI in DIG patients may be attributed to proteolysis of the intact form of TFPI in these patients. The increased level of the truncated form of TFPI may be a useful index for the diagnosis of DIG. (C) 1999 Wiley-Liss, Inc.