Circulating Syndecan-1 Levels Are Associated with Chronological Coagulofibrinolytic Responses and the Development of Disseminated Intravascular Coagulation (DIC) After Trauma: A Retrospective Observational Study

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Jul 14

PMID 37445421

Authors

Hironori Matsumoto

Suguru Annen

Naoki Mukai

Muneaki Ohshita

Satoru Murata

Yutaka Harima

Shirou Ogawa

Mitsuo Okita

Yuki Nakabayashi

Satoshi Kikuchi

Jun Takeba

Norio Sato

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate the association between endotheliopathy represented by high levels of circulating syndecan-1 (SDC-1) and coagulofibrinolytic responses due to trauma, which can lead to disseminated intravascular coagulation (DIC).

Methods: We retrospectively evaluated 48 eligible trauma patients immediately admitted to our hospital and assessed SDC-1 and coagulofibrinolytic parameters for 7 days after admission. We compared the longitudinal changes of coagulofibrinolytic parameters and SDC-1 levels between two groups (high and low SDC-1) according to median SDC-1 value on admission.

Results: The median circulating SDC-1 level was 99.6 (61.1-214.3) ng/mL on admission, and levels remained high until 7 days after admission. Coagulofibrinolytic responses assessed by biomarkers immediately after trauma were correlated with SDC-1 elevation (thrombin-antithrombin complex, TAT: = 0.352, = 0.001; antithrombin, AT: = -0.301, < 0.001; plasmin-α-plasmin inhibitor complex, PIC: = 0.503, = 0.035; tissue plasminogen activator, tPA: = 0.630, < 0.001). Sustained SDC-1 elevation was associated with intense and prolonged coagulation activation, impairment of anticoagulation, and fibrinolytic activation followed by inhibition of fibrinolysis, which are the primary responses associated with development of DIC in the acute phase of trauma. Elevation of circulating SDC-1 level was also associated with consumption coagulopathy and the need for transfusion, which revealed a significant association between high SDC-1 levels and the development of DIC after trauma (area under the curve, AUC = 0.845, cut-off value = 130.38 ng/mL, = 0.001).

Conclusions: High circulating levels of syndecan-1 were associated with intense and prolonged coagulation activation, impairment of anticoagulation, fibrinolytic activation, and consumption coagulopathy after trauma. Endotheliopathy represented by SDC-1 elevation was associated with trauma induced coagulopathy, which can lead to the development of DIC.

Citing Articles

Effect on Syndecan-1 and Hyaluronan Levels Depending on Multiple Organ Failure, Coagulopathy and Survival: An Observational Study in Major Trauma Patients.

Braunstein M, Annecke T, Frey K, Kusmenkov T, Wornle M, Ney L J Clin Med. 2024; 13(22).

PMID: 39597912 PMC: 11595190. DOI: 10.3390/jcm13226768.

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