Author Affiliation: Department of Critical Care Medicine, Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Laboratory, University of Pittsburgh, Pittsburgh, Pa (Dr Angus), and Department of Medicine, McMaster University, Hamilton, Ontario (Dr Crowther).
In this issue of THE JOURNAL, Abraham and colleagues1 report
the results of an international, multicenter randomized controlled trial (optimized
phase 3 tifacogin in multicenter international sepsis trial [OPTIMIST]) that
compared a 96-hour infusion of recombinant tissue factor pathway inhibitor
(TFPI) with placebo in 1754 critically ill patients with sepsis and mild coagulopathy
(international normalized ratio [INR] ≥1.2). Tissue factor pathway inhibitor,
a naturally occurring anticoagulant, modulated the coagulation cascade but
did not impact the mortality rate.
Angus DC, Crowther MA. Unraveling Severe SepsisWhy Did OPTIMIST Fail and What's Next?. JAMA. 2003;290(2):256-258. doi:10.1001/jama.290.2.256