The Clinical Significance of Fibrin Monomers

Refaai, Majed A.; Riley, Paul; Mardovina, Tatsiana; Bell, Phoenix

doi:10.1055/s-0038-1673684

Cited by 45 publications

(47 citation statements)

References 43 publications

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“…Additional biomarkers of in vivo enhanced thrombin generation, such as SFC, may thus provide some additional useful information for managed care of COVID-19 [56]. SFC could also be an earlier marker of DIC than D-dimers, of which the concentration increases only after clot lysis has begun [56].…”

Section: Hemostasis Assessment In the Laboratorymentioning

confidence: 99%

“…The half-life is hence longer than that of fibrinopeptides A and B (3-5 min), thrombin-antithrombin complexes (TAT; 10-15 min) and prothrombin fragments 1 + 2 (90 min) [63], so that is less dependent on the time of blood collection, considering that activation of coagulation cannot be a continuous, steady process. Nevertheless, the influence of the time elapsed between thrombosis onset, blood collection, and measurement, as well as the potential influence of anticoagulants remain to be studied [56]. For all assays, in particular for fibrinopeptides and TAT, the influence of preanalytical artifacts (thrombin formed during blood collection and processing) should be considered [56].…”

Section: Fibrinogen Degradation Productsmentioning

confidence: 99%

“…This would be consistent with the observation that SFC levels, which are thought to only depend on intra-vascular fibrin deposition, remain low in most COVID-19 patients despite high D-dimer levels [ 30 ]. Additional biomarkers of in vivo enhanced thrombin generation, such as SFC, may thus provide some additional useful information for managed care of COVID-19 [ 56 ]. SFC could also be an earlier marker of DIC than D-dimers, of which the concentration increases only after clot lysis has begun [ 56 ].…”

Section: Hemostasis Assessment In the Laboratorymentioning

confidence: 99%

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Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

Hardy¹,

Lecompte

Douxfils

et al. 2020

Thrombosis J

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Coronavirus disease 2019 (COVID-19) is associated with extreme inflammatory response, disordered hemostasis and high thrombotic risk. A high incidence of thromboembolic events has been reported despite thromboprophylaxis, raising the question of a more effective anticoagulation. First-line hemostasis tests such as activated partial thromboplastin time, prothrombin time, fibrinogen and D-dimers are proposed for assessing thrombotic risk and monitoring hemostasis, but are vulnerable to many drawbacks affecting their reliability and clinical relevance. Specialized hemostasis-related tests (soluble fibrin complexes, tests assessing fibrinolytic capacity, viscoelastic tests, thrombin generation) may have an interest to assess the thrombotic risk associated with COVID-19. Another challenge for the hemostasis laboratory is the monitoring of heparin treatment, especially unfractionated heparin in the setting of an extreme inflammatory response. This review aimed at evaluating the role of hemostasis tests in the management of COVID-19 and discussing their main limitations.

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Section: Hemostasis Assessment In the Laboratorymentioning

confidence: 99%

Section: Fibrinogen Degradation Productsmentioning

confidence: 99%

Section: Hemostasis Assessment In the Laboratorymentioning

confidence: 99%

See 1 more Smart Citation

Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

Hardy¹,

Lecompte

Douxfils

et al. 2020

Thrombosis J

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“…The texts were based on scientific articles published on PubMed ® and Scientific Electronic Library Online (SciELO) databases, from 2014 to 2018. (19)(20)(21)(22)(23) The non-systematized search was performed using the terms "tromboembolismo venoso" and "venous thromboembolism", in the fields "title or abstract". Studies addressing the definition of the disease, signs and symptoms, risk factors and preventive measures were selected.…”

Section: First Stage: Preparation Of the Manualmentioning

confidence: 99%

Development and validation of an informative manual on venous thromboembolism for the lay population

Takara

Ferreira

Murakami

et al. 2020

Einstein (São Paulo)

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Objective: To develop an informative manual on venous thromboembolism prevention for the lay population and to estimate evidences of content and face validity. Methods: A methodological study conducted in three stages. The first stage was the preparation of the manual, followed by content validation with cardiovascular specialists who judged clarity, theoretical relevance and practical pertinence on a 4-point Likert scale. Items with a content validity index ≤0.75 were revised and re-evaluated. The last stage was the face validation by lay people, who were interviewed regarding item understanding and visual appearance. Items with more than 80.0% positive opinions were considered adequate. Results: The manual was developed containing nine illustrations, definition of the disease, risk factors, signs and symptoms, and preventive measures. In the first assessment round, the validity index was 1.0 for the text of all sections, with suggestions for language adjustments. As to the illustrations, the validity indexes ranged from 0.67 to 1.0. In the second round, the validity index reached 1.0 for all items. A total of 40 lay people participated in the face validation, and all considered the paper type and font size appropriate, as well as the font used as readable; 97.5% were able to understand the information contained in the manual; 98.0% considered it esthetically beautiful; and 90.0% considered the reading not tiresome. Conclusion: The informative manual on venous thromboembolism prevention was prepared, its content validated by experts, and considered appropriate by the lay population. These results suggest that the manual may be used as a preventive educational strategy for venous thromboembolism.

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“…Fibrin monomers (FM) can possibly improve diagnosis if used together with D-dimer for the exclusion of VTE. 4 The specificity of D-dimer is low at the chosen cutoff, with false positive results in up to 30% of tested patients with suspected VTE. 5 The low specificity is partially due to increased levels in patients with comorbidities.…”

Section: Introductionmentioning

confidence: 95%

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

Farm

Antovič

Schmidt

et al. 2020

TH Open

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Introduction For acute venous thromboembolism (VTE), a biomarker with higher specificity than D-dimer would be of great clinical use. Thrombin generation and overall hemostatic potential (OHP) reflect the hemostatic balance by globally assessing multiple coagulation factors and inhibitors. These tests discriminate between healthy controls and patients with a prothrombotic tendency but have yet to be established as clinical biomarkers of VTE. Objective This study compares endogenous thrombin potential (ETP) and OHP to D-dimer and fibrin monomers (FM) in outpatients with suspected VTE. Methods A cross-sectional diagnostic study where 954 patients with suspected pulmonary embolism or deep venous thrombosis were recruited consecutively from the medical emergency department at Karolinska University Hospital. D-dimer, FM, OHP, and ETP were analyzed in a subpopulation of 60 patients with VTE and 98 matched controls without VTE. VTE was verified either by ultrasonography or computed tomography and clinical data were collected from medical records. Results Compared with healthy controls, both VTE and non-VTE patients displayed prothrombotic profiles in OHP and ETP. D-dimer, FM, ETP area under the curve (AUC), and ETP Tlag were significantly different between patients with VTE and non-VTE. The largest receiver-operating characteristic AUCs for discrimination between VTE and non-VTE, were found in D-dimer with 0.94, FM 0.77, and ETP AUC 0.65. No useful cutoff could be identified for the ETP or the OHP assay. Conclusion Compared with D-dimer, neither ETP nor OHP were clinically viable biomarkers of acute venous thrombosis. The data indicated that a large portion of the emergency patients with suspected VTE were in a prothrombotic state.

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The Clinical Significance of Fibrin Monomers

Cited by 45 publications

References 43 publications

Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

Development and validation of an informative manual on venous thromboembolism for the lay population

Diagnostic Accuracy in Acute Venous Thromboembolism: Comparing D-Dimer, Thrombin Generation, Overall Hemostatic Potential, and Fibrin Monomers

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