PMID- 29790645
OWN - NLM
STAT- Publisher
LR  - 20240227
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
DP  - 2018 May 23
TI  - The fibrinogen prothrombin time-derived method is not useful in patients 
      anticoagulated with low molecular weight heparins or rivaroxaban.
LID - 10.1111/jth.14158 [doi]
AB  - Essentials Fibrinogen prothrombin time-derived (FIBPT-d) behavior in 
      anticoagulated patients is under studied. FIBPT-d method overestimates fibrinogen 
      in rivaroxaban and low molecular weight heparin samples. Unfractionated heparin 
      and dabigatran samples showed similar bias to the control group. Rabbit brain and 
      human recombinant thromboplastin behavior was different in rivaroxaban samples. 
      SUMMARY: Background The fibrinogen prothrombin time-derived (FIBPT-d) method with 
      photo-optical coagulometers is easy and economical. However, there are few 
      reports on the behavior of this test on samples from patients anticoagulated with 
      direct oral anticoagulants or low molecular weight heparin (LMWH). Objective To 
      compare fibrinogen results obtained with the Clauss (FIB C) method and the 
      FIBPT-d method with two thromboplastins in anticoagulated patients. Population 
      The study population comprised 295 consecutive anticoagulated patients: 99 
      treated with vitamin K antagonists (VKAs), 49 treated with unfractionated heparin 
      (UFH), 47 treated with LMWH, 50 treated with rivaroxaban, 50 treated with 
      dabigatran, and 100 normal controls (NCs). Methods Dabigatran samples were 
      analyzed by the use of FIB C with HemosIL Fibrinogen C or 100 NHI thrombin units 
      mL(-1) reagents; rabbit brain and human recombinant thromboplastins with HemosIL 
      PTFibrinogen HS plus (HS) and Recombiplastin 2G (RP) were used for FIBPT-d 
      method. Heparin and rivaroxaban levels were assessed with HemosIL Liq antiXa with 
      specific calibrators; dabigatran levels were determined with the HemosIL Direct 
      Thrombin Inhibitor Assay. All assays were performed on the ACL TOP platform in 
      two laboratories. Percentage biases for the FIBPT-d method versus the FIB C 
      method were calculated by the use of Bland-Altman plots. Results Positive biases 
      of the FIBPT-d method versus the FIB C method with both thromboplastins were seen 
      in NC samples (13.7% and 18.9% for HS and RP, respectively), but biases with HS 
      in rivaroxaban and VKA patient samples were higher than that in NC samples, at 
      31.9% and 34.0%, respectively. LMWH patient samples showed higher bias than NC 
      samples: 26.5% and 29.3.0% with HS and RP, respectively. UFH and dabigatran 
      patient samples showed similar bias as NC samples. Conclusion The FIBPT-d method 
      should not be used in anticoagulated patients, because the FIBPT-d mathematical 
      algorithm has been validated only in normal subjects, so overestimation could 
      occur in these patients.
CI  - (c) 2018 International Society on Thrombosis and Haemostasis.
FAU - Duboscq, C
AU  - Duboscq C
AD  - Servcio de Hematologia Hospital Britanico de Buenos Aires, Buenos Aires, 
      Argentina.
FAU - Martinuzzo, M E
AU  - Martinuzzo ME
AD  - Grupo Bioquimico, Laboratorio Central del Hospital Italiano de Buenos Aires, 
      Instituto Universitario Hospital Italiano, Buenos Aires, Argentina.
FAU - Ceresetto, J
AU  - Ceresetto J
AD  - Servcio de Hematologia Hospital Britanico de Buenos Aires, Buenos Aires, 
      Argentina.
FAU - Lopez, M
AU  - Lopez M
AD  - Grupo Bioquimico, Laboratorio Central del Hospital Italiano de Buenos Aires, 
      Instituto Universitario Hospital Italiano, Buenos Aires, Argentina.
FAU - Barrera, L
AU  - Barrera L
AD  - Grupo Bioquimico, Laboratorio Central del Hospital Italiano de Buenos Aires, 
      Instituto Universitario Hospital Italiano, Buenos Aires, Argentina.
FAU - Oyhamburu, J
AU  - Oyhamburu J
AD  - Grupo Bioquimico, Laboratorio Central del Hospital Italiano de Buenos Aires, 
      Instituto Universitario Hospital Italiano, Buenos Aires, Argentina.
FAU - Stemmelin, G
AU  - Stemmelin G
AD  - Servcio de Hematologia Hospital Britanico de Buenos Aires, Buenos Aires, 
      Argentina.
LA  - eng
PT  - Journal Article
DEP - 20180523
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
OTO - NOTNLM
OT  - blood coagulation tests
OT  - dabigatran
OT  - fibrinogen analysis
OT  - heparin
OT  - low molecular weight
OT  - rivaroxaban
EDAT- 2018/05/24 06:00
MHDA- 2018/05/24 06:00
CRDT- 2018/05/24 06:00
PHST- 2017/06/08 00:00 [received]
PHST- 2018/05/24 06:00 [pubmed]
PHST- 2018/05/24 06:00 [medline]
PHST- 2018/05/24 06:00 [entrez]
AID - S1538-7836(22)02205-X [pii]
AID - 10.1111/jth.14158 [doi]
PST - aheadofprint
SO  - J Thromb Haemost. 2018 May 23. doi: 10.1111/jth.14158.