ArticleActa neurochirurgica2025
The time course of alpha 2-plasmin inhibitor and plasmin-alpha 2-plasmin inhibitor complex levels in patients with traumatic brain injury.
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Plasma Proteomic Signatures of Coagulopathy Following Traumatic Injury: Links to Biomechanics and Patient Outcomes.Shock (Augusta, Ga.) · 2026Article
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10 authors.
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Abstract
backgroundIn its acute phase, traumatic brain injury (TBI) is notable for disturbances in the coagulation/fibrinolysis system. Plasmin, alpha 2-plasmin inhibitor (α2-PI), and their complex (plasmin-α2-PI complex [PIC]) are important components of the coagulation-fibrinolytic system, but their time courses in the acute phase of TBI and their association with long-term prognosis are unknown.
methodsWe conducted a retrospective analysis of 84 consecutive patients with isolated TBI, during which plasma α2-PI and PIC levels were measured at the time of arrival, as well as at 3, 6, and 12 h, and on days 1, 3, and 7 post-injury. Differences in plasma α2-PI and PIC levels between the good outcome group (extended Glasgow Outcome Scale [GOS-E] of 5-8 at 6 months post-injury) and the poor outcome group (GOS-E of 1-4 at 6 months post-injury) were analyzed using a generalized linear mixed model (GLMM). The hematoma volume of the initial CT scan upon admission and the follow-up CT scan was evaluated using CT volumetry, and then the relationship between changes in hematoma volume and plasma levels of α2-PI and PIC at admission was examined.
resultsAbnormally high plasma PIC levels were observed at admission in 97.6% of the patients. In the GLMM adjusted for covariates, the poor outcome group had significantly lower plasma α2-PI activity from admission to 3 days post-injury and significantly higher plasma PIC levels from admission to 6 h post-injury compared to the good outcome group. A negative correlation was found between α2-PI activity at admission and changes in hematoma volume (Spearman's correlation coefficient, r = - 0.587, p = 0.001).
conclusionsThese findings suggest that plasmin was activated and fibrinolysis enhanced immediately after injury in most patients, while in a subset of patients, hematoma expansion due to the suppression of fibrinolytic inhibition by α2-PI negatively affected the outcome.
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