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Comparative Study
. 2021 Jan-Dec:27:1076029620943300.
doi: 10.1177/1076029620943300.

Biomarkers of Platelet Activation and Their Prognostic Value in Patients With Sepsis-Associated Disseminated Intravascular Coagulopathy

Gracelene Wegrzyn  1   2 , Amanda Walborn  1   2 , Matthew Rondina  3 , Jawed Fareed  1   2 , Debra Hoppensteadt  1   2
Affiliations
Comparative Study

Biomarkers of Platelet Activation and Their Prognostic Value in Patients With Sepsis-Associated Disseminated Intravascular Coagulopathy

Gracelene Wegrzyn et al. Clin Appl Thromb Hemost. 2021 Jan-Dec.

Abstract

Sepsis-associated disseminated intravascular coagulation (DIC) is related to marked hemostatic changes such as transient thrombocytopenia secondary to the endogenous activation and consumption of platelets. This study measured markers of platelet function in 103 adult ICU patients with clinically established sepsis-associated DIC to determine the biomarker association with disease severity. Patients were categorized as having no DIC, nonovert DIC, or overt DIC using the International Society of Thrombosis and Hemostasis scoring system. Plasma levels of CD40L, platelet factor 4 (PF4), platelet-derived microparticles, and microparticle-associated tissue factor were quantified. Markers of platelet activation were significantly elevated in patients with DIC compared to healthy individuals. This increase was independent of platelet count. Levels of PF4 differed based on the severity of DIC and differentiated nonsurvivors and survivors. These findings suggest that the markers of platelet activation in DIC may not be regulated by the number of circulating platelets and may be independent of the factors leading to their consumption.

Keywords: biomarkers; disseminated intravascular coagulation; platelets; sepsis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Baseline platelet biomarker levels stratified by disseminated intravascular coagulation score. Significance calculated between groups using the Kruskal-Wallis analysis of variance with Dunn multiple comparison test and P < .05 as the cutoff for significance (indicated by *). Data are shown as mean ± SEM. (A) Levels of Microparticles-tissue factor (MP-TF); (B) Levels of CD 40 ligand (CD40L); (C) Levels of Platelet factor 4 (PF4); (D) Levels of Microparticles (MP).
Figure 2.
Figure 2.
Baseline platelet biomarker levels in patients stratified by platelet count. Significance calculated between groups using the Kruskal-Wallis analysis of variance with Dunn multiple comparison test and P < .05 as the cutoff for significance (indicated by *). Data are shown as mean ± SEM. (A) Levels of Microparticles-tissue factor (MP-TF); (B) Levels of CD 40 ligand (CD40L); (C) Levels of Platelet factor 4 (PF4); (D) Levels of Microparticles (MP).
Figure 3.
Figure 3.
Association of baseline platelet biomarker levels with survival. Significance calculated between groups using the Mann-Whitney test with P < .05 as the cutoff for significance (indicated by *). Data are shown as mean ± SEM. (A) Levels of Microparticles-tissue factor (MP-TF); (B) Levels of CD 40 ligand (CD40L); (C) Levels of Platelet factor 4 (PF4); (D) Levels of Microparticles (MP).
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