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Med Intensiva. 2017 Nov;41(8):475-482. doi: 10.1016/j.medin.2016.10.008. Epub 2016 Dec 27.

Reduced thrombin activatable fibrinolysis inhibitor and enhanced proinflammatory cytokines in acute coronary syndrome.

[Article in English, Spanish]

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Department of Biomedical Engineering, Dalian University of Technology, No. 2 Ling Gong Road, Ganjingzi District, Dalian city 116024, China. Electronic address:
Vasculocardiology Department of the First Affiliated Hospital, Jinzhou Medical University, No. 2 of Street 5, Guta District, Jinzhou city 121000, China.
Technology Center of Liaoning MEDI Biological Company, No. 166 of Xianghuai Road, Economic and Technological Development Zone, Benxi city 117004, China.



A study was made of the changes in the serum levels of thrombin activatable fibrinolysis inhibitor (TAFI), proinflammatory cytokines and acute phase proteins in the acute stage of acute coronary syndrome (ACS), in order to explore the possibility of using TAFI as a biomarker for ACS risk assessment.


A total of 211 patients with ACS were enrolled, and healthy subjects were used as controls. Blood samples were taken within 24h after admission. Serum TAFI levels were determined by immunoturbidimetry. Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were determined by enzyme linked immunosorbent assay (ELISA). Procalcitonin (PCT) and C-reactive protein (CRP) levels were measured by gold-immunochromatographic assay.


Serum TAFI levels in ACS patients were significantly decreased versus the controls. The IL-1β, IL-6, TNF-α, PCT and CRP levels were markedly higher in the ACS patients than in the controls. Correlation analysis revealed a strong negative correlation between TAFI concentration and the IL-1β, IL-6, TNF-а, PCT and CRP levels in ACS patients and in controls. Multivariate logistic regression analysis suggested decreased serum TAFI to be an independent risk factor for ACS (OR 9.459; 95% CI 2.306-38.793; P=0.002). The area under the receiver operating characteristic (ROC) curve for TAFI was 0.872 (95% CI 0.787-0.909; P<0.001). The optimum TAFI cutoff point for the prediction of ACS was 24μg/ml, with a sensitivity of 75.83% and a specificity of 72.57%.


These findings suggest that TAFI can be useful as a potential biomarker for ACS risk assessment.


Acute coronary syndrome; Acute phase protein; Cardiopatía coronaria; Citocina proinflamatoria; Coronary disease; Inhibidor de la fibrinólisis activado por trombina; Proinflammatory cytokine; Proteína de la fase aguda; Síndrome coronario agudo; Thrombin activatable fibrinolysis inhibitor

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