Evaluation of Thrombin Activatable Fibrinolysis Inhibitor (TAFI) in Patients with β-Thalassemia

Abstract

Background: Thalassemia is an inherited disorder of hemoglobin (Hb) synthesis that results in reduced or absent production of globin chain. Hypercoagulable state in thalassemia is a well-recognized event. Thrombin activatable fibrinolysis inhibitor (TAFI) is an enzyme considered to play an important role in the regulation of fibrinolysis by the coagulation system. With this background, the present study was conducted to know the role of TAFI as a contributing factor in hemostatic alteration state in adults with β-thalassemia. Aim: The aim of this article is to evaluate the level of TAFI and hematological parameters in splenectomized and non-splenectomized β-thalassemia patients and to compare their levels with normal subjects. Materials and Methods: This case–control study was conducted in 56 adult thalassemic patients. The plasma TAFI level was evaluated by the ELISA technique. Results: There was a significant reduction in TAFI levels in all thalassemic patients when compared with thalassemia minor patients and controls (P < 0.0001). The TAFI level was significantly lower in the splenectomized group when compared with the non-splenectomized group (P < 0.0001), and the TAFI level was significantly lower in the thalassemia major group when compared with the thalassemia intermediate group (P < 0.0001). There was a significantly higher prothrombin time and activated partial thromboplastin time level in thalassemic major and intermediate patients when compared with thalassemia minor patients and controls (P < 0.001). Conclusion: The TAFI enzyme level could be an important predictor for hemostatic alteration. Its level can be considered as a helpful marker for monitoring and follow-up of thalassemic patients for early and proper intervention to minimize complications.