Plasma Soluble Fibrin Is Useful for the Diagnosis of Thrombotic Diseases

Abstract

Background: Soluble fibrin (SF) is a form of fibrinogen that is activated by thrombin and is considered to be useful for the diagnosis of the prethrombotic state or thrombosis. Methods: Plasma levels of fibrin-related markers (FRMs), such as SF, D-dimer, fibrinogen, and fibrin degradation prioduct (FDP) levels in critically ill patients, were examined for the diagnosis of disseminated intravascular coagulation (DIC), venous thromboembolism (VTE), peripheral arterial thromboembolism (PATE), acute myocardial infarction (AMI), and acute cerebral infarction (ACI). Results: FRMs showed the usefulness in diagnosing DIC and VTE and the cutoff values of D-dimer, FDP, and SF for DIC were 7.2–7.8 μg/mL, 10.0 μg/mL, and 9.5 μg/mL, respectively. The cutoff values of D-dimer and FDP for VTE were similar to the 97.5th percentile values of healthy volunteers, while the cutoff value of SF was 6.9 μg/mL. In AMI and ACI, the cutoff values of D-dimer and FDP were lower than the 97.5 percentile values of healthy volunteers. A receiver operating characteristic analysis for all thrombosis cases showed that an adequate cutoff value in only SF among FRMs was higher than the confidence interval of healthy volunteers. Only SF had high sensitivity for thrombosis, as the FDP/SF ratio was markedly low for ACI, AMI and VTE. Conclusions: FRMs, especially D-dimer and FDP, were useful for diagnosing thrombosis with hyperfibrinolysis (e.g., DIC). As SF showed high sensitivity for predominantly thrombotic diseases, including arterial thrombosis, such as ACI and AMI, a high SF value suggests the possibility of an association with thrombosis. Finally, SF is the most useful marker for raising suspicion of an association with thrombosis, especially arterial thrombosis.

Improving Traditional Post Mortem Healthcare—The Cross-Sectional Use of Blood-Based Biomarkers

“…With this dissolution, fragments of protein are released into the bloodstream. One such specific fragment, which is formed only upon the degradation of cross-linked fibrin, is D-dimer [108]. Plasma concentrations of D-dimer show fibrin turnover in the circulation and are ultimately related to subsequent mortality from any cause [109].…”

Biomarkers of Hypercoagulability in COVID-19

“…Mie Prefectural General Medical Center, Department of General and Laboratory Medicine; Mie 510-8561, Japan; wadahide@clin.medic.mie-u.ac.jp; Tel. : +81-59- This issue focuses on the pathophysiology of coronavirus disease 2019 (COVID-19) [1][2][3][4][5][6] and several biomarkers for hypercoagulability in patients with disseminated intravascular coagulation (DIC) [7,8,9], acute cerebral infarction (ACI) [7,10], acute myocardial infarction (AMI) [7], venous thromboembolism (VTE) [7], and COVID-19 [5,6]. Patients with COVID-19 develop hypercoagulability, and COVID-19 is frequently associated with various thromboses.…”

“…Patients with COVID-19 develop hypercoagulability, and COVID-19 is frequently associated with various thromboses. Soluble C-type lectin-like receptor 2 (sCLEC-2) is released from activated platelets [11], and fibrinogen and fibrin degradation products (FDPs), D-dimer, and soluble fibrin (SF) include fibrin-related markers (FRMs) [7]. Thus, sCLEC-2 is considered to be a biomarker for platelet activation, as well as microvascular or arterial thrombi, and FRMs are considered to be biomarkers for venous and microvascular thrombi.…”

“…Both FDP and D-dimer, which are used in the scoring system for the diagnosis of DIC, are the best biomarkers for diagnosing DIC. They are also useful for the exclusion of VTE, but not for the diagnosis of AMI or ACI [7,8]; on the other hand, SF is useful for the diagnosis of not only DIC and VTE, but also AMI and ACI. Although elevated sCLEC-2 levels are considered useful for the diagnosis of DIC, AMI, and ACI, in which platelet activation occurs, sufficient evidence for the diagnosis of thrombosis has not yet been established (Figure 1).…”

Reference Value Fibrin Monomer in Healthy Children: A Cross-Sectional Study

“…Establishing FM reference values for healthy children can aid in the diagnosis and treatment of hemorrhagic and thrombotic diseases. 10 This is especially beneficial for lower-middle-income countries like Vietnam, where standardized benchmarks can significantly enhance healthcare strategies and treatment outcomes for pediatric thrombotic disorders.…”