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CC BY-NC-ND 4.0 · Thromb Haemost 2024; 124(01): 040-048
DOI: 10.1055/a-2145-7139
New Technologies, Diagnostic Tools and Drugs

Characterization and Usefulness of Clot-Fibrinolysis Waveform Analysis in Critical Care Patients with Enhanced or Suppressed Fibrinolysis

Takumi Tsuchida 
1   Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
,
Mineji Hayakawa 
1   Division of Acute and Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Hokkaido University Faculty of Medicine, Sapporo, Japan
,
Osamu Kumano 
2   Sysmex Corporation, Kobe, Japan
3   Health and Medical Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Takamatsu, Japan
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Abstract

Introduction Recently, clot-fibrinolysis waveform analysis (CFWA), which is a coagulation and fibrinolysis global assay based on assessing the activated partial thromboplastin time with tissue-type plasminogen activator, was developed. This study aimed to investigate the characteristics of CFWA using plasma samples from patients in the critical care unit.

Materials and Methods The fibrinolysis times using CFWA were measured in 298 plasma samples. These samples were divided into three groups based on the reference interval (RI) of fibrinolysis time using CFWA: shortened group, less than RI; within group, within RI; prolonged group, more than RI. The coagulation and fibrinolysis markers, including D-dimer, plasmin–α2 plasmin inhibitor complex (PIC), fibrin monomer complex (FMC), plasmin–α2 plasmin inhibitor (α2-PI), plasminogen (Plg), and fibrinogen (Fbg) were analyzed and compared among the three groups.

Results The FMC level decreased in the order of shortened, within, and prolonged groups, and the decrease was statistically significant among all three group pairs. The opposite tendency was observed for Fbg and fibrinolysis-related markers of α2-PI and Plg, and significant differences were recognized in all pair comparisons except for between within and prolonged groups in Plg. The mean values of the fibrinolysis markers D-dimer and PIC in all three groups were higher than the cut-off values, and the PIC value differed significantly between the within and prolonged groups.

Conclusion The fibrinolysis reaction was detected in all three groups, but the status differed. CFWA has the potential to reflect the fibrinolysis status in one global assay.

Keywords

clot-fibrinolysis waveform analysis - coagulation and fibrinolysis - fibrin - tissue-type plasminogen activator - fibrinolysis

Data Availability Statement

The corresponding author can disclose the data on request.


Authors' Contribution

T.T. contributed to the conception of the study and manuscript preparation. O.K. contributed to the sample measurements, data analysis, creation of figures, and revision of the intellectual content. M.H. contributed to the sample collection, manuscript preparation, and revision of the intellectual content. All authors have read and approved the final manuscript version before submission.




Publication History

Received: 05 March 2023

Accepted: 10 July 2023

Accepted Manuscript online:
01 August 2023

Article published online:
05 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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