How high is the true fibrinogen content of fibrinogen standards?

Furlan, Miha; Felix, R.; Escher, Niko; Lämmle, Bernhard

doi:10.1016/0049-3848(89)90266-1

Cited by 18 publications

(15 citation statements)

References 13 publications

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“…59 While this standard (and its successor, the currently available Second International Fibrinogen Standard) 60 have improved the situation, some commercial reference materials appear erroneously calibrated when compared with the International Standard (see above).…”

Section: Calibration Standardsmentioning

confidence: 99%

Plasma fibrinogen

2004

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Fibrinogen is the major plasma protein coagulation factor. Low plasma fibrinogen concentrations are therefore associated with an increased risk of bleeding due to impaired primary and secondary haemostasis. Fibrinogen is a classical positive acute-phase reactant protein and is an independent predictor of coronary heart disease events. This review considers available methods for measurement of fibrinogen and makes recommendations as to their appropriate use.Total clottable fibrinogen assays are the definitive and reference method for plasma fibrinogen measurement. However, they are time-consuming and are rarely required in clinical practice. Clotting rate assays remain the routine method of choice for investigation, monitoring and treatment of bleeding disorders associated with low plasma fibrinogen concentrations. They are appropriately sited in haematology or haemostasis laboratories, with facilities for further relevant investigations, and expert advice from consultant haematologists on appropriate management. They have also been used in the majority of studies investigating increasing fibrinogen concentrations as a cardiovascular risk factor. Prothrombin-time derived assays are widely used, because they are less expensive and come at no extra cost with prothrombin time assays. However, their results vary widely with analysers and reagents, show discrepancies with clotting rate assays for both low and normal plasma fibrinogen samples, and at present they are not recommended by routine clinical use. Immunoassays (radial immunodiffusion, enzyme-linked immunosorbent assay or nephelometric) are useful in (a) differentiating hypofibrinogenaemia from dysfibrinogenaemia, and (b) assessing cardiovascular risk and acute-phase reactions. Unlike clottable fibrinogen assays, immunoassays can be performed in dipotassium edetate anticoagulated samples.

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Section: Calibration Standardsmentioning

confidence: 99%

Plasma fibrinogen

2004

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“…This hap pened even when, according to the manufac turer, the appropriate methods were applied. As early as 1989 Furlan et al [21] had criti cized the varying quality of commercially available standards for fibrinogen. The Na tional Institute for Biological Standards and Controls then devised a standard for fibrino gen (89/644) as reference for all commercial plasma pools, in order to minimize their vari ations [22], As the different reference plasmas have a low comparability, their application as calibrators leads to further variations in fi brinogen levels.…”

Section: Discussionmentioning

confidence: 99%

“…It is furthermore influenced by exercise, diet and cigarette smoking [5][6][7], Since Fibrinogen has been reported to be an independent risk factor for ischemic heart disease [8][9][10] and is also associated with stroke and peripheral arterial disease [11], measurement of plasma fibrino gen levels has become more frequent in the routine coagulation laboratory. However, the great variety of Fibrinogen determination methods [12][13][14][15][16][17][18][19][20] and the deviation From the declared value of commercially available standards [21] which led to the introduction of an international standard for plasma fibrin ogen measurement in 1992 [22] seem to be responsible for the partially incomparable re sults and divergent clinical interpretation of Fibrinogen levels when measured in difFerent laboratories [23]. With the adaptation of a batroxobin-based kinetic test [19] for deter mination of Fibrinogen on automated clinical chemistry analyzers of the BM/Hitachi series [24], this method is expected to be much more widely used, also by laboratories not special ized in coagulation.…”

Section: Introductionmentioning

confidence: 99%

Comparison of a New Automated Kinetically Determined Fibrinogen Assay with the 3 Most Used Fibrinogen Assays (Functional, Derived and Nephelometric) in Austrian Laboratories in Several Clinical Populations and Healthy Controls

Halbmayer¹,

Haushofer²,

Schön³

et al. 1995

Pathophysiol Haemos Thromb

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A new automated kinetically determined fibrinogen assay was measured in plasmas of healthy subjects and three clinical cohorts (acute-phase reaction, liver cirrhosis and fibrinolytic therapy) that were expected to show normal, high and low levels of fibrinogen. The results were compared with the results of fibrinogen measurement using the derived method, the method according to Clauss and an immunological-nephelometric method. Altogether, the best correlation was achieved between the kinetic and the derived method. However, results from the derived method were generally higher than values obtained through the kinetic method. This was particularly true for high concentration levels above 400 mg/dl (patients with acute phase reaction) as well as for plasmas containing fibrin(ogen) degradation products and low concentrations of fibrinogen (below 150 mg/dl). Fibrinogen determinations in several commercial plasma pools with declared fibrinogen levels show remarkable heterogeneity when different methods were applied. To improve the discernment of fibrinogen determinations we suggest adjustment of standard preparations to international reference materials and the specification of the method used. Furthermore the attending physician is asked to cast a critical eye on fibrinogen values with regard to the used method of determination.

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“…However, and unfortunately, in clinical prac tice a great variety of heterogenous commercial calibrator plasmas are used [2]. In our paper [3], we used four different and for the different methods recommended calibration materials not in spite of the wellknown fact of deviations from the declared value but because of this effect!…”

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confidence: 99%