Predictive value of thrombin–antithrombin III complex and tissue plasminogen activator–inhibitor complex biomarkers in assessing the severity of early‐stage acute pancreatitis

Abstract Background and Aim The development of acute pancreatitis (AP) is strongly linked to blood clotting and fibrinolysis issues. Modern clinical practices now utilize advanced blood markers like thrombin–antithrombin III complex (TAT), plasmin‐α2‐plasmin inhibitor complex, thrombomodulin (TM), and tissue plasminogen activator–inhibitor complex (t‐PAIC) to assess thrombosis risk. Our study used a highly sensitive chemiluminescence technique to measure these markers in AP patients, aiming to determine their early predictive value for AP severity. Methods There were 173 patients with AP, all of whom developed symptoms within 72 h; 102 individuals had onset symptoms within 48 h. The biomarkers were measured upon admission before determining the severity of AP. Results The levels of TAT, plasmin‐α2‐plasmin inhibitor complex, TM, and t‐PAIC were significantly higher in the severe acute pancreatitis (SAP) group compared with the mild acute pancreatitis and moderate severe acute pancreatitis groups. For the patients within 72 h of onset, TAT, TM, and t‐PAIC predicted the occurrence of SAP. For the patients within 48 h of onset, TAT and t‐PAIC predicted the occurrence of SAP. The area under the curve (AUC) of prediction models is similar to Bedside Index for Severity in Acute Pancreatitis (BISAP) but significantly higher than C‐reactive protein ( P < 0.05). Notably, t‐PAIC had a larger AUC than TAT, BISAP, and C‐reactive protein. Conclusion In the initial 48 h, plasma TAT and t‐PAIC levels may predict the development of SAP. Within 72 h, plasma levels of TAT, TM, and t‐PAIC may predict the development of SAP, and the TAT + TM + t‐PAIC prediction model achieved a maximum AUC of 0.915, comparable to BISAP.