Fibrinogen Concentration Research Articles

The Role of Inflammatory and Hemostatic Markers in the Prediction of Severe Acute Pancreatitis: An Observational Cohort Study.

Acute pancreatitis (AP) is a serious inflammatory disease of the pancreas that can lead to significant morbidity and increased mortality. The special role of inflammation and disruption of the hemostatic system in the development of severe forms of the disease is known, however, the relationship between inflammatory and anti-inflammatory cytokines and thromboelastogram parameters has not been sufficiently studied. The aim of this study is to assess the prognostic significance of thromboelastogram parameters, interleukin-6, and interleukin-22 levels in assessing the risk for developing severe forms of acute pancreatitis. Data from 149 patients with acute pancreatitis were included in the analysis. The classification of AP was performed according to the 2012 Revision of the Atlanta Classification. Data including gender, age, lab tests, radiological information, and prognosis were included. The following scales were used to assess severity: SOFA scale and BISAP scale. IL-6 and IL-22 were analyzed at 24 h and 48 h after the onset of symptoms. The collected TEG parameters included K-time, R-value, and Maximum amplitude value at admission. All patients were divided into three groups: mild, moderate-severe, and severe pancreatitis. Statistically significant differences were found between the groups in the IL-6 level at the first measurement and on day 2 of the study. IL-22 values were also higher in the group with severe pancreatitis, however, on day 2, its level became lower compared to the group of patients with moderate and mild pancreatitis. Statistically significant differences were found in the level of K-time, R-value, Maximum amplitude, fibrinogen concentration, and platelets count, demonstrating a hypercoagulation state in severe pancreatitis at admission. The conducted logistic regression showed that the factors associated with the development of severe forms are the number of points on the BISAP scale, the level of interleukin-6 in the first 24 hours of the disease, delta IL-22, and K-time. (AUC = 0.948). The study highlights that both IL-6 and IL-22 play crucial roles in the inflammatory cascade of severe acute pancreatitis. Their levels, along with specific hemostasis parameters like K-time and BISAP score, serve as reliable early predictors of disease severity.

Evaluation of Some Haemorheologic Parameters amongst Automotive Spray Painters in Port Harcourt, Nigeria

Background/Objectives: Automotive Spray-Painters are at a higher risk of exposure to hazardous chemicals such as polycyclic aromatic hydrocarbons – benzene inclusive, and heavy metals which may cause adverse health outcomes. The aim of the study was to evaluate effect of exposure to spray paints on some haemorheological parameters in individuals involved in automotive spray painting within Port Harcourt Metropolis. Method: This case control study recruited 52 participants: 30 automotive spray-painters and 22 controls. The study was carried out in Port Harcourt Metropolis, Nigeria. Venous blood samples were drawn from the participants (age 20 to 65 years) and examined for packed cell volume, erythrocyte sedimentation rate, fibrinogen and haemoglobin. Semi-structured questionnaire was used to obtain information from participants. Result: Participants from painting occupation had significantly higher ESR (p = 0.0450) as a result of increase in number of years in Automotive Spray-Painting. Increased ESR may be an indication of inflammation in the body. There was no statistical significance between Automotive Spray-Painters and control subjects when values of haemoglobin concentration, packed cell volume, fibrinogen concentration and erythrocyte concentration was compared in Automotive Spay-Painters, however, their values were increased than that control subjects at p<0.05. Conclusion: The study revealed that prolonged inhalation of benzene and other aromatic toxic compounds in paints caused slight increase in haemorheological parameters (PCV, HB, ESR and fibrinogen) of Automotive Spray-Painters due to exposure to paint fumes, a risk factor for inflammation of vital organs, venous thrombosis and thromboembolism; and predisposes Spray-Painters to many health disorders which can affect their lungs, heart, blood vessels, and ultimately the transport of oxygen to the brain.

Impact of Short-Term Diesel Exhaust Exposure on Prothrombotic Markers in Chronic Obstructive Pulmonary Disease: A Randomized, Double-Blind, Crossover Study.

Rationale: Growing evidence suggests that air pollution exposure is a major risk factor in chronic obstructive pulmonary disease (COPD) that is associated with an increased prothrombotic state and adverse cardiovascular outcomes. However, much of this work is based on observational data or human exposure studies involving younger participants. The biological causality and mechanism of air pollution-induced prothrombotic response in patients with COPD remain to be explored. Objectives: The main aim of this work was to investigate the impact of short-term diesel exhaust (DE) exposure on circulating prothrombotic markers-fibrinogen and plasminogen activator inhibitor-1 (PAI-1)-and urinary eicosanoids in patients with COPD. Methods: Twenty-nine research participants were recruited in this randomized, double-blind, crossover, controlled human exposure study to DE. Participants included former smokers with and without mild or moderate COPD (ex-smokers [ES] and COPD group) and healthy never-smokers without COPD (nonsmoker [NS] group). Each participant was exposed to DE (300 μg/m3 of particulate matter with an aerodynamic diameter ≤2.5 μm) and filtered air for 2 hours on different occasions, in randomized order, separated by a 4-week washout. Blood and urine samples were collected before and 24 hours after each exposure. Plasma fibrinogen and serum PAI-1 concentrations were quantified using enzyme-linked immunosorbent assays. Urinary eicosanoid concentrations were quantified using ultraperformance liquid chromatography coupled to tandem mass spectrometry. Linear mixed-effects models were used for statistical comparisons. Results: Participants with COPD showed an increase in plasma fibrinogen (effect estimate, 1.27 [1.06-1.53]; P = 0.01) after DE relative to filtered air, but no significant DE-associated change in serum PAI-1 (0.95 [0.87-1.04]; P = 0.26). In never-smokers and ex-smokers without COPD, fibrinogen (NS group, 1.10 [0.99-1.23]; P = 0.08; ES group, 0.86 [0.68-1.09]; P = 0.08] and PAI-1 (NS group, 1.12 [0.96-1.32]; P = 0.15; ES group, 0.90 [0.79-1.03]; P = 0.13) were not changed after DE exposure. Participants with COPD showed a DE-attributable increase in urinary thromboxane B2 (TXB2) metabolite concentrations as follows: 11-dehydro-TXB2 (1.45 [1.02-2.08]; P = 0.04) and 2,3-dinor-TXB2 (1.45 [1.05-2.00]; P = 0.03). Conclusions: Participants with COPD had increased plasma fibrinogen and urinary TXB2 metabolites after short-term DE exposure, suggesting they may be more susceptible to a pollution-attributable prothrombotic response than healthy control subjects or ex-smokers without COPD. Clinical trial registered with www.clinicaltrials.gov (NCT02236039).

Hypercoagulation after Hospital Discharge in Acute Severe Ulcerative Colitis: A Prospective Study.

Venous thromboembolism is a serious complication during and following hospitalization with acute severe ulcerative colitis (ASUC). We evaluated serial thrombotic profiles of patients with ASUC from the point of hospitalization up to 12 weeks post-discharge and compared these with control patients with quiescent UC. Twenty-seven patients with ASUC and 25 control patients with quiescent ulcerative colitis (UC) were recruited. Thrombin generation (endogenous thrombin potential), rotational thromboelastometry (EXTEM and FIBTEM maximum clot firmness), pro-coagulant factors, anti-coagulant factors and fibrinolytic markers were assessed for those with ASUC on admission (day 1), day 5, 4 weeks and at 8 to 12 weeks. These assessments were performed on a single occasion for control patients. Endogenous thrombin potential and maximum clot firmness were significantly elevated in patients with ASUC compared to controls and remained significantly elevated for 4 weeks and for 8 to 12 weeks after admission (P< 0.05), respectively. Von Willebrand Factor (VWF) antigen, factor VIII, Clauss fibrinogen concentration and platelet count were significantly increased from presentation to 8 to 12 weeks and are likely to account for changes in the global haemostatic profile. Global measures of haemostasis demonstrated that patients with ASUC were pro-thrombotic compared to controls with quiescent colitis. This difference was maintained 8 to 12 weeks after the initial presentation, supporting clinical observations that patients with ASUC have an elevated risk of VTE after hospital discharge.

Comparing the coagulation and platelet parameters of womenwith premature ovarian insufficiency with those of age-matched controls: A case-control study.

This study aimed to compare the coagulation and platelet parameters in women with spontaneous premature ovarian insufficiency (POI) with those in age-matched controls. This case-control study recruited 202 women with POI and 202 age-matched women with benign gynecological diseases as controls. Coagulation parameters, including prothrombin time (PT), international normalized ratio (INR), activated partial thromboplastin time (APTT), and thrombin time (TT), fibrinogen, and platelet parameters, including platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW), were compared between women with POI and controls. Factors associated with coagulation and platelet parameters were also analyzed in women with POI. In women with POI, higher fibrinogen levels and PDW, lower PLT, MPV, and PCT levels, and shorter TT were observed (p < 0.001). Linear regression analysis further revealed that women with POI were more likely to exhibit increased serum fibrinogen levels (β = 0.465, 95% confidence interval [CI] 0.366-0.564) and PDW (β = 0.340, 95% CI 0.300-0.379), decreased TT (β = -1.101, 95% CI -1.233--0.969), PLT (β = -50.985, 95% CI -65.087--36.882), MPV (β = -1.498, 95% CI -1.875 to -1.120), PCT levels (β = -0.084, 95% CI -0.095--0.973). Additionally, follicle-stimulating hormone levels were positively associated with fibrinogen levels in women with POI. There were no statistically significant differences in PT, INR, and APTT between women with POI and controls. Women with POI exhibited decreased platelet numbers, abnormal platelet morphology, and elevated fibrinogen concentrations, potentially implicating POI's etiopathogenesis or contributing to an increased risk of cardiovascular disease in women with POI. No coagulation abnormalities were observed in women with POI.

Risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.

With the widespread use of hemocoagulase in patients with gastrointestinal bleeding, clinicians have become increasingly concerned about coagulation disorders associated with this medication. Risk factors for hypofibrinogenemia associated with hemocoagulase are poorly understood. To determine risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding. We performed a retrospective analysis of the medical documentation of hospitalized patients treated with hemocoagulase for gastrointestinal bleeding. Hypofibrinogenemia was defined as a decrease in plasma fibrinogen concentration to less than 2.0 g/L. The included patients were divided into two groups: acquired hypofibrinogenemia group and non-hypofibrinogenemia group. We used logistic regression analysis to identify potential risk factors and established risk assessment criteria by employing a receiver operating characteristic curve. There were 36 patients in the acquired hypofibrinogenemia group and 73 patients in the non-hypofibrinogenemia group. The hypofibrinogenemia group showed higher rates of intensive care unit admissions (P = 0.021), more female patients (P = 0.005), higher in-hospital mortality (P = 0.027), larger hemocoagulase doses (P = 0.026), more Packed Red Cells transfusions (P = 0.024), and lower baseline fibrinogen levels (P < 0.000). Binary logistic regression was employed to examine the risk factors associated with acquired hypofibrinogenemia. The analysis revealed that baseline fibrinogen [odds ratio (OR) 0.252, 95%CI: 0.137-0.464, P < 0.000], total hemocoagulase doses (OR 1.074, 95%CI: 1.015-1.137, P = 0.014), and female gender (OR 2.856, 95%CI: 1.015-8.037, P = 0.047) were statistically significant risk factors. Higher doses of total hemocoagulase, female gender, and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.

A ten-year experience with the diagnosis of von Willebrand disease in Mexico based on a cost-effective strategy

BackgroundVon Willebrand disease (VWD), is the most common inherited bleeding disorder worldwide, but its diagnosis is complicated, expensive, and poorly evaluated in several countries. ObjectiveTo report our long-term experience with the diagnosis of VWD based on a cost-effective strategy. MethodsWe studied 802 Mexican patients, men and women, children, and adults, with clinical suspicion of VWD. The following tests were performed: blood count, bleeding time, prothrombin time, activated partial thromboplastin time, fibrinogen concentration, VWF antigen, ristocetin cofactor activity, collagen binding assay, ristocetin-induced platelet aggregation, FVIII activity, and VWF multimers analysis. ResultsVWD was diagnosed in 639 patients; 582 had type 1 VWD (91.1%). Type 2 VWD was found in 52 patients (8.1%). Type 2A was present in 25 cases (48.1%), while types 2B and 2M accounted for 21 (40.4) and six (11.5%) cases, respectively. Type 3 VWD was present in five patients (0.8%). The mean age of patients with VWD was 25.3 years (range: 2–71) for males and 22.1 (range: 1–54) for females. The diagnosis was inconclusive in 40 cases (5.0%) and was discarded in 123 (15.3%). Blood group O was the most common among patients with VWD. ConclusionUsing a low-cost diagnostic strategy, we confirmed that VWD is as common in Mexico as in other countries. Review of the patient's history is mandatory when VWD is suspected, although laboratory confirmation may be difficult and expensive. The consequences of a lack of accurate and timely diagnosis affect the promptness and quality of treatment.

Enzymatic hydrolysis of duck blood protein produces stable bioactive peptides: Pilot-scale production, identification, and stability during gastrointestinal and plasma digestion

This study addresses the valorization of duck blood, an underutilized protein-rich by-product from the poultry industry, into bioactive protein hydrolysates with antioxidant and ACE inhibitory properties. Raw and heat-treated duck blood were compared as substrates for enzymatic hydrolysis using Neutrase and Papain. Gel electrophoresis revealed that heat treatment reduced fibrinogen content, while FTIR analysis showed that heat treatment modified the protein structure, increasing β-sheet content from 21.13 % to 34.96 %. Heat-treated duck blood hydrolyzed by Neutrase exhibited superior hydrolysis (9.53 %) and protein recovery (60.28 %) compared to raw blood. Pilot-scale production (1000 L) enhanced hydrolysate yield and maintained bioactive properties. LC-MS/MS analysis identified five novel bioactive peptides derived from the hydrolysate's 4-h simulated gastrointestinal (GI) digestion, with WMHVR demonstrating the highest antioxidant and ACE inhibitory activities. Molecular docking simulations revealed that WMHVR competitively inhibits ACE by binding to the S1, S2, and S′ pockets through van der Waals and hydrogen bonding interactions. The GI-hydrolysate and identified peptides maintained bioactivity during simulated GI and blood plasma digestion, with ACE inhibition increasing over time. This research transforms food industry waste into functional protein hydrolysates, offering applications in nutraceuticals and functional foods while promoting sustainable practices through waste protein valorization.

Establishment and validation of a predictive model for lower extremity deep vein thrombosis in patients with traumatic pelvic fractures

BackgroundPatients with traumatic pelvic fracture (TPF) are at high risk for developing deep vein thrombosis (DVT). However, there is still no unified standard on how to distinguish high-risk groups for DVT in patients with TPF and how to accurately use anticoagulants at present.ObjectivesThis observational study aimed to establish a DVT risk nomogram score (DRNS) model for TPF patients, and to explore the value of the DRNS model as a clinical guideline in the prevention of DVT with low molecular weight heparin (LMWH).MethodsIndependent risk factors of lower extremity DVT were screened through Lasso regression and logistic regression. A DRNS model was established per this.ResultsThe independent risk factors of DVT included combined femoral fractures, age ≥ 40 years old, BMI (body mass index) ≥ 24 kg/m2, ISS score, fibrinogen concentration, and the minimum concentration of ionized calcium within 48 h after admission. The optimal cutoff value for DRNS was 78.5. In the low-risk population of DVT (DRNS < 78.5), there was no statistical significance of variation about the incidence of DVT progression between the LMWH once a day (qd) group and the LMWH once every 12 h (q12h) group, with P = 0.323. In the high-risk population of DVT (DRNS ≥ 78.5), the incidence of DVT progression in the LMWH qd group was significantly higher than that in the LMWH q12h group, with P = 0.002.ConclusionsThe DRNS model based on independent risk factors of DVT could stratify the risk of DVT for TPF patients, and it was able to provide more precise DVT drug prevention plans for clinicians.

Combined fibrinogen concentration and neutrophil-to-lymphocyte ratio, an integrative model of the inflammatory response and coagulation cascades, for predicting prognosis in patients with upper tract urothelial carcinoma.

Inflammation and coagulation cascades are closely correlated with cancer occurrence and progression. This study investigated the prognostic value of the combination of plasma fibrinogen level and neutrophil-to-lymphocyte ratio (F-NLR) in patients with upper tract urothelial carcinoma (UTUC). The predictive ability of the F-NLR for overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) was initially established and then further validated in patients who underwent radical nephroureterectomy for UTUC. As a result, patients were divided into three groups following the establishment of cut-off values for the NLR (≥2.53 vs. <2.53) and fibrinogen (≥4.55 vs. <4.55) through receiver operating characteristic (ROC) curve analysis: F-NLR score 0 (low fibrinogen and low NLR), 2 (high fibrinogen and high NLR), or 1 (remaining patients). The F-NLR score was then identified as an independent risk factor for OS, CSS, and PFS (all P-value <0.05) by multivariate regression analysis in both the training and validation cohorts. In addition, F-NLR-based nomograms for OS, CSS, and PFS were developed and evaluated using the concordance index (C-index) and calibration curves. The integration of the F-NLR into existing nomograms improved predictive accuracy compared to the use of nomograms without the F-NLR score. This suggests that the addition of F-NLR is beneficial for enhancing the accuracy of prognosis prediction in patients with UTUC. The F-NLR score may serve as a powerful predictor for patients with UTUC.

High Intraocular Concentration of Fibrinogen Regulates Retinal Function Via the ICAM-1 Pathway.

Diabetic retinopathy (DR) is a significant complication of diabetes mellitus that can lead to progressive visual impairment. This study aimed to elucidate the role of fibrinogen, a protein whose serum and intraocular concentrations are elevated in patients with diabetes and DR, in the pathogenesis of DR. The changes in the protein levels of the neuronal marker tubulin-β3 (TUBB3) and retinal response induced by the intravitreal injections of 1× phosphate-buffered saline, 40mg/mL of fibrinogen, and 40mg/mL of fibrinogen in combination with anti-intracellular adhesion molecule-1 (ICAM-1) antibody in normal mice were observed using immunofluorescence, western blotting, and electroretinography. High concentrations of fibrinogen led to a decrease in the expression of TUBB3 in immunofluorescence and western blotting. The amplitudes of the positive scotopic threshold response and b-wave were notably reduced after the injection of fibrinogen, indicating potential damage to the retinal ganglion cells. The co-administration of anti-ICAM-1 antibody effectively mitigated these fibrinogen-induced changes, indicating that fibrinogen-induced damage is mediated via the ICAM-1 pathway. The present study underscores the significance of elevated intraocular fibrinogen levels as a pathogenic factor in DR. Involvement of the fibrinogen/ICAM-1 pathway presents new avenues for therapeutic intervention, especially in patients with treatment-resistant conditions.

Association Between Laboratory Coagulation Parameters and Postpartum Hemorrhage in Preterm and Term Caesarean Section: A Retrospective Analysis.

Background: Deranged antepartum laboratory parameters may be risk factors for postpartum hemorrhage (PPH). However, whether this is also valid in women who give birth prematurely is currently unknown. Methods: We performed a retrospective single-center study to assess the role of antepartum hemoglobin, platelet count, fibrinogen, activated partial thromboplastin time, and prothrombin time as risk factors for PPH following caesarean section. We defined PPH as documented blood loss of at least 1 L and/or transfusion of red blood cell concentrates. We stratified the included patients according to gestational age: extremely preterm (gestational age < 28 weeks), very preterm (gestational age between 28 and 32 weeks), late and moderate preterm (gestational age between 32 and 37 weeks), and term (gestational age ≥ 37 weeks). Results: We included 1734 patients, 112 (6%) of whom had PPH. In total, 19 patients (10%) were in the extremely preterm group, 13 patients (10%) were in the very preterm group, 44 patients (9%) were in the late and moderate preterm group, and 36 patients (4%) were in the term group. Hemoglobin predicted PPH in all gestational age groups. Platelet count was associated with PPH in term, but not in preterm patients. Fibrinogen was associated with PPH in late prematurity but not in term patients and not in patients with early or extreme prematurity. Conclusions: Antepartum hemoglobin was the only factor predicting PPH in preterm and term caesarean sections. Platelet count and fibrinogen concentration were associated with PPH in term and late prematurity, respectively, but not in earlier stages of prematurity.

Point-of-care viscoelastic coagulation monitoring device shows promise for informing resuscitation strategies in a canine hemorrhagic shock model.

To use a point-of-care viscoelastic coagulation monitoring device (VCM-Vet; Entegrion) and traditional tests to assess hemostatic changes during hemorrhagic shock in dogs. 8 healthy, purpose-bred Beagles were enrolled in a hemorrhagic shock model conducted from September through December 2021. Dogs were anesthetized, had baseline hemostatic variables measured after blood pressure was stabilized at 70 to 80 mm Hg for 10 minutes (T1), had blood withdrawn from a jugular vein to achieve a mean blood pressure of 40 ± 5 mm Hg for 10 minutes (T2), were resuscitated with 100% shed blood, and then had hemostatic variables evaluated 10 minutes later (T3). At each time point, hemostatic variables were measured with traditional tests (Hct, WBC count, platelet count, mean platelet volume, prothrombin time, activated partial thromboplastin time [aPTT], and concentrations of fibrinogen, antithrombin, and D-dimer) and the VCM-Vet device (clot time, clot formation time, α-angle, maximum clot formation, amplitude at 10 minutes [A10], amplitude at 20 minutes [A20], clot lysis index at 30 minutes [LI30], and clot lysis index at 45 minutes [LI45]). All dogs survived without complication. At T2 and T3 (vs T1), samples had significantly higher coagulability (increased median α-angle, A10, and A20) and fibrinolysis (decreased median LI30 and LI45) and significantly longer aPTT; however, all values remained within reference limits. The use of VCM-Vet helped identify complex hemostatic disturbances in dogs with hemorrhagic shock. The use of VCM-Vet shows promise in aiding veterinarians in optimizing resuscitation strategies based on real-time clotting data.

Variability in individual native fibrin fiber mechanics

Fibrin fibers are important structural elements in blood coagulation. They form a mesh network that acts as a scaffold and imparts mechanical strength to the clot. A review of published work measuring the mechanics of fibrin fibers reveals a range of values for fiber extensibility. This study investigates fibrinogen concentration as a variable responsible for variability in fibrin mechanics. It expands previous work to describe the modulus, strain hardening, extensibility, and the force required for fiber failure when fibers are formed with different fibrinogen concentrations using lateral force atomic force microscopy. Analysis of the mechanical properties showed fibers formed from 1 mg ml-1and 2 mg ml-1fibrinogen had significantly different mechanical properties. To help clarify our findings we developed two behavior profiles to describe individual fiber mechanics. The first describes a fiber with low initial modulus and high extensible, that undergoes significant strain hardening, and has moderate strength. Most fibers formed with 1 mg ml-1fibrinogen had this behavior profile. The second profile describes a fiber with a high initial modulus, minimal strain hardening, high strength, and low extensibility. Most fibrin fibers formed with 2 mg ml-1fibrinogen were described by this second profile. In conclusion, we see a range of behaviors from fibers formed from native fibrinogen molecules but various fibrinogen concentrations. Potential differences in fiber formation are investigated with SEM. It is likely this range of behaviors also occursin vivo. Understanding the variability in mechanical properties could contribute to a deeper understanding of pathophysiology of coagulative disorders.

Thrombin generation, fibrin clot permeation and lysis in patients with severe mitral regurgitation undergoing transcatheter edge-to-edge mitral valve repair: mitral fibrin study

Abstract Background/Introduction The management of heart failure (HF), particularly in the context of reduced ejection fraction, is further complicated by an increased risk of thromboembolic events. Structural alterations of both left ventricle and mitral valve contribute to mitral regurgitation (MR). However, the body of evidence provides inconclusive insights into the relationship between MR and thromboembolic risk. Purpose This study aimed to investigate the impact of transcatheter edge-to-edge repair (TEER) on thrombin generation, clot permeation and clot lysis time in HF patients with severe MR eligible for mitral TEER. Methods A cohort of 31 HF patients with severe MR undergoing TEER underwent systematic evaluation at three time points. Coagulation parameters, including fibrinogen concentration, thrombin generation, fibrin clot permeability (Ks), and clot lysis time (CLT), were assessed. Comprehensive evaluations also covered echocardiographic, laboratory, and clinical parameters. Results TEER induced changes in fibrinogen levels (p=0.009, visit 3 vs. visit 2) and improved fibrin clot properties over a 50-day follow-up (Ks, p=0.005, visit 3 vs. visit 2). No significant differences were observed among time points in analyzed blood clot parameters. Linear regression, incorporating thrombin generation variables, Ks, and CLT for delta NT-proBNP, highlighted CLT as the sole predictor of NT-proBNP change between visit 2 and visit 1 (p=0.03; R2=0.18). Conclusions MR reduction through TEER led to transient alterations in fibrinogen concentration and improved fibrin clot characteristics. Additionally, baseline CLT emerged as a significant predictor of early NT-proBNP reduction, emphasizing its role as a key indicator of the hemodynamic response to TEER.

The Association of Serum Fibrinogen Levels With the Severity of Primary Postpartum Hemorrhage: A Prospective Study.

Postpartum hemorrhage (PPH) remains a major cause of maternal mortality and morbidity worldwide. Coagulation disorders are a major risk factor for PPH that have not been studied adequately. Fibrinogen, a plasma glycoprotein, is integral to hemostasis and is involved in the final process of the coagulation cascade. Fibrinogen levels increase with advancing pregnancy probably because of an increase in estrogen levels and reach a peak (~5g/L) in the third trimester of pregnancy. However, in the postpartum period, the fibrinogen concentration shows a decreasing trend. The purpose of the study was to study the serum fibrinogen levelin patients with PPH and to find its association with the severity of primary postpartum hemorrhage. Methodology: Patients were selected according to inclusion and exclusion criteria. Written and informed consents were taken. Routine investigations were done on admission and special investigations like red blood cell count, prothrombin time, international normalized ratio,activated partial thromboplastin time, and serum fibrinogen were done later when the patient developed PPH. Serial samples of all PPH patients for serum fibrinogen levels at0, 1, 2, 4, and 24 hours were taken to study the serum fibrinogen levels and data were analyzed. Result: The mean fibrinogen level on admission was 3.92 ± 0.92 g/lin non-severe PPH and 2.03 ± 0.97 g/l in the severe PPH group.Fibrinogen levels in the non-severe group remained < 4.46 g/l at 0, 1, 2, 4, and 24 hours. In the severe group, fibrinogen levels were < 2.89 g/l at 0, 1, 2, and 4 hours and it was 2.44 ± 1.06g/l in the 24-hour samples. Statistical significance was found in all the fibrinogen values among the two study groups (p = 0.001). Our results showed that zero-hour fibrinogen levels correlate significantly with the aggravation of PPH and levels <2 g/L can serve as a predictor for progression to severe PPH.

Deposit of Red Blood Cells at low concentrations in evaporating droplets is dominated by a central edge growth

Evaporation of blood droplets and diluted blood samples is a topic of intensive research, as it is considered a potential low-cost diagnostic tool. So far, samples with a volume fraction down to a few percent of red blood cells have been studied, and these were reportedly dominated by a “coffee-ring” deposit. In this study, samples with lower volume fractions were used to investigate the growth of the evaporative deposit from sessile droplets in more detail. We observed that blood samples and salt solutions with less than 1% volume fraction of red blood cells are dominated by a central deposit. We characterized the growth process of this central deposit by evaporating elongated drops and determined that it is consistent with the Kardar-Parisi-Zhang process in the presence of quenched disorder. Our results showed a sensitivity of the deposit size to fibrinogen concentration and the shape of red blood cells, suggesting that this parameter could be developed into a new and cost-effective clinical marker for inflammation and red blood cell deformation.

Safety of Fibrinogen Concentrate for Correcting Perioperative Bleeding-Associated Hypofibrinogenemia in Adults: A Single-Center Experience.

Background: Surgery often leads to bleeding associated with hypofibrinogenemia. Supplementation with fibrinogen concentrate appears to be effective and safe, although findings from studies are inconsistent. The primary aim of this study was to assess the safety of fibrinogen concentrate during the perioperative period. Methods: This single-centre, prospective, observational study included adult patients undergoing scheduled or emergency surgery related to bleeding coagulopathy and the administration of fibrinogen concentrate. Patients were followed until their discharge from the institution. Comprehensive data were collected, including age, sex, type of surgery, associated comorbidities, anticoagulant and/or anti-aggregating therapy, and the number of blood transfusions. Laboratory data on plasma fibrinogen concentration, haemoglobin, and platelet count before and after surgery were also collected. The primary outcomes were the mortality rate at discharge and any reported thrombotic or thromboembolic events, including deep vein thrombosis, pulmonary embolism, and myocardial infarction. Results: The study included 91 adult patients who had undergone surgery, with 29 surgeries (32%) conducted in an emergency setting. The mean age was 59.2 years, and 53.8% were male. Major bleeding occurred in 29 cases, mainly in older males and those on anticoagulant therapy. The pre-operative fibrinogen level averaged 161 mg/dL, and the average dosage of fibrinogen concentrate administered was 2.7 g. Eight patients died (8.8%), mostly due to septic or cardiogenic shock, with deaths being more frequent in emergency settings. Thromboembolic events occurred in eight patients, none of whom died. No additional adverse events directly related to the administration of fibrinogen concentrate were reported. Conclusions: Our findings suggest a favourable safety profile for fibrinogen concentrate in surgical patients, as evidenced by a low incidence of deaths and thromboembolic events, which were primarily attributed to other factors. Future research should strive to increase statistical robustness to further illuminate clinically significant patient safety measures.

A novel snake venom C-type lectin-like protein modulates blood coagulation by targeting von Willebrand factor and coagulation factor IX

Snake venom C-type lectin-like proteins (CLPs) belong to the nonenzymatic proteins. To date, no CLP with both platelet and coagulation factors activating activities has been reported. In this study, a novel CLP, termed protocetin, with molecular weight of 29.986 kDa, was purified from the Protobothrops mucrosquamatus venom (PMV). It consists of α- and β-chains, with 67% similarity in their N-terminal sequence. Protocetin activates glycoprotein Ib (GPIb) by binding to von Willebrand factor (vWF), inducing platelet aggregation. It also activates the intrinsic coagulation pathway by binding to coagulation factor IX. After injection of protocetin into mice at dose of 0.5 µg/g or 1.5 µg/g, it resulted in activation of platelets, a notable reduction in platelet count and prolonged tail bleeding time. Additionally, the plasma activated partial thromboplastin time (APTT) was significantly extended, and the fibrinogen concentration was markedly reduced. Thrombelastogram comfirmed the anticoagulation effect of protocetin. Notably, no microthrombosis was observed in tissues of lung, liver and kidney within 1 h after injection of protocetin into the mice at dose of 0.5 µg/g. This study revealed protocetin as a novel CLP from PMV that has dual functions in activating platelet and coagulation factor IX, thereby modulates coagulation in vivo. This work contributes to a better understanding of the structure and function of snake venom CLP.

Predicting Progressive Hemorrhagic Injury Following Traumatic Brain Injury by the Evaluation of D-Dimer/Fibrinogen Ratio

Abstract Background Prognosis of traumatic brain injury (TBI) significantly depends on the incidence of progressive hemorrhagic injury (PHI). The present study was conducted to assess whether D-dimer/fibrinogen ratio can predict PHI among the patients with TBI. Materials and Methods A total of 150 patients were included in this retrospective study; among them 72 had PHI and 78 did not have PHI. Demographic, clinical, radiological, and laboratory parameters including plasma D-dimer and plasma fibrinogen levels and subsequently D-dimer/fibrinogen ratio were evaluated. Independent t-test, Mann–Whitney U test, chi-square test, Fisher's exact test, and multivariate logistic regression were used for statistical analysis. Results Age, injury time, first computed tomography time, Glasgow Coma Scale scores, unreactive pupils, abnormal cisterns, midline shift above 5 mm, skull base fracture, epidural hematoma, subdural hematoma, intraventricular hemorrhage, cerebral hematoma, brain contusion, plasma D-dimer concentration, plasma fibrinogen concentration, and D-dimer/fibrinogen ratio vary significantly between PHI and non-PHI groups (p &lt; 0.05). Multivariate logistic regression showed that the Glasgow Coma Scale score (odds ratio [OR], 0.531; 95% confidence interval [CI], 0.436–0.648; p = 0.004) and D-dimer/fibrinogen ratio (OR, 3.784; 95% CI, 2.086–6.867; p = 0.027) were the two independent predictors for PHI. Conclusion D-dimer/fibrinogen ratio is a useful parameter in predicting the incidence of PHI among the patients with TBI.