Evaluation of a Soluble Fibrin Assay in Patients with Suspected Deep Vein Thrombosis

Ginsberg, Jeffrey S.; Siragusa, Sergio; Douketis, James D.; Johnston, Marilyn; Moffat, Karen A.; Stevens, P; Brill-Edwards, Patrick; Panju, Akbar; Patel, Ameen

doi:10.1055/s-0038-1649832

Cited by 19 publications

(18 citation statements)

References 36 publications

(27 reference statements)

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“…28 Thus, thrombin generation may occur without stimulating fibrin production, a situation previously defined as a prethrombotic state. 28 Once the thrombin inhibitory capacity is exceeded, however, soluble fibrin is formed, with increased levels noted with venous thromboembolism 29,30 and myocardial infarction. 31 In the present study, we observed a 76% increase in soluble fibrin in Values are meanϮSEM except D-dimer, which is shown as mean (25th to 75th percentile).…”

Section: Discussionmentioning

confidence: 99%

Postmenopausal Hormone Replacement Therapy Increases Coagulation Activity and Fibrinolysis

Teede

McGrath

Smolich

et al. 2000

ATVB

124

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Abstract-Hormone replacement therapy (HRT) appears to be cardioprotective in postmenopausal women; however, concerns exist over its thrombogenic effects. To address the effects of combined HRT on coagulation and fibrinolysis, we have measured circulating markers of these processes in a double-blind placebo-controlled trial. Forty-two healthy postmenopausal women aged 50 to 75 years received continuous combined HRT with 2 mg estradiolϩ1 mg norethisterone or placebo for 6 weeks. Hormone profiles were measured at baseline, and lipid and hemostatic parameters were measured at baseline and after 6 weeks of therapy. Baseline characteristics were similar in the 2 groups. With change from baseline the main outcome measure, HRT increased the markers of coagulation (prothrombin fragments 1ϩ2, 0.

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Section: Discussionmentioning

confidence: 99%

Postmenopausal Hormone Replacement Therapy Increases Coagulation Activity and Fibrinolysis

Teede

McGrath

Smolich

et al. 2000

ATVB

124

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“…These methods were used in order to study the correlation between the decrease in APC ratio and changes in blood coagulation activity. The importance of increased markers of coagulation activation is uncertain but increased levels are found during thromboembolism and in patients with thrombophilia (21). Moreover decreased, dose-dependent levels are found during anticoagulant treatment (22).…”

Section: Discussionmentioning

confidence: 99%

APC Resistance and other Haemostatic Variables during Pregnancy and Puerperium

Kjellberg

Andersson²,

Rosén³

et al. 1999

Thromb Haemost

156

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SummaryForty-eight healthy pregnant women were studied prospectively and longitudinally. Blood sampling was performed at 10-15, 23-25, 32-34 and 38-40 weeks of gestation, within one week and at eight weeks postpartum. Classic and modified activated protein C ratio decreased as pregnancy progressed. In the third trimester 92% of the ratios measured with the classic test were above the lower reference level whereas all modified test ratios were normal. Slight activation of blood coagulation was shown with increased levels of prothrombin fragment 1+2, soluble fibrin and D-dimer. Fibrinogen, factor VIII and plasminogen activator inhibitor type 1 and type 2 increased. Protein S and tissue plasminogen activator activity decreased. Protein C remained unchanged. No correlation was found between the decrease in classic APC ratio and changes in factor VIII, fibrinogen, protein S, prothrombin fragment 1+2 or soluble fibrin, nor between the increase in soluble fibrin and changes in prothrombin fragment 1+2, fibrinogen and D-dimer.

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“…The AUCs calculated for fibrin monomer (0.724 in the total patient group and 0.683 in the DVT-unlikely group) were lower than those for D-dimer tests. However, some authors have suggested that fibrin monomer tests have similar efficacy as measuring D-dimer levels in the exclusion diagnosis of venous thromboembolism [9,19,20]. The results of our study indicate the usefulness of fibrin monomer in the different logistic models containing D-dimer assays for the exclusion of DVT.…”

Section: Discussionmentioning

confidence: 49%

“…Unlike Ddimer, fibrin monomer is used to monitor the proteolytic cleavage of fibrinogen by thrombin and is therefore a marker of thrombin activity [21,22]. With regard to the difference between fibrin monomer and D-dimer, fibrin monomer reflects the early phase of DVT, whereas Ddimer reflects secondary fibrinolysis after clot formation [19]. The combined measurement of fibrin monomer as a parameter for fibrin generation and D-dimer for fibrin dissolution may provide valuable information for DVT diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Excluding deep venous thrombosis in symptomatic outpatients: is fibrin monomer aid to D-dimer analysis?

Dopsaj

Bogavac-Stanojević

Vasić

et al. 2009

Blood Coagulation &Amp; Fibrinolysis

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Many studies have investigated the clinical accuracy of the D-dimer test in combination with pretest probability score for deep venous thrombosis (DVT) exclusion. However, few have evaluated its potential when combined with additional markers such as fibrin monomer. The aim of this study was to test the incremental usefulness of fibrin monomer for DVT screening in a bi-marker approach. This was achieved by adding the fibrin monomer to logistic models that included different D-dimer tests. Plasma concentrations of D-dimer and fibrin monomer were measured in 96 outpatients suspected of having DVT and in 76 patients selected from the total patient group according to pretest probability score (termed the DVT-unlikely group). We constructed receiver operating characteristic curves for three different D-dimer assays. Predictive probabilities from different logistic regression models and pair-wise comparisons of the areas under the receiver operating characteristic curve (AUCs) were calculated without and with fibrin monomer included in the models. For all three D-dimer assays, the AUCs were higher in the DVT-unlikely group compared with AUCs in the total patient group [but the differences were without statistical significance (P > 0.05)]. The calculated fibrin monomer AUCs (0.724 in the total patient group and 0.683 in the DVT-unlikely group) were lower than the D-dimer tests' AUCs. The AUCs obtained from logistic regression models that included the three D-dimer tests in the total patient group and the DVT-unlikely group were significantly increased when fibrin monomer was included in the model to such an extent that the AUCs for one of them indicated outstanding discriminative abilities. Simultaneous D-dimer and fibrin monomer determination provides a more valuable approximation for DVT exclusion compared with just D-dimer analysis. Bearing in mind that the fibrin monomer assay is now both more practical and more suited for routine clinical use, fibrin monomer determination could be a more commonly used parameter together with D-dimer and pretest probability score for DVT diagnosis in the future.

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Evaluation of a Soluble Fibrin Assay in Patients with Suspected Deep Vein Thrombosis

Cited by 19 publications

References 36 publications

Postmenopausal Hormone Replacement Therapy Increases Coagulation Activity and Fibrinolysis

Postmenopausal Hormone Replacement Therapy Increases Coagulation Activity and Fibrinolysis

APC Resistance and other Haemostatic Variables during Pregnancy and Puerperium

Excluding deep venous thrombosis in symptomatic outpatients: is fibrin monomer aid to D-dimer analysis?

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