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Plasma fibrinogen.

Gordon D O Lowe1, Ann Rumley, Ian J Mackie

  • 1Department of Medicine, University of Glasgow Glasgow, Scotland, UK. gdl1j@clinmed.gla.ac.uk

Annals of Clinical Biochemistry
|December 14, 2004
PubMed
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Accurate fibrinogen measurement is crucial for diagnosing bleeding disorders and assessing cardiovascular risk. This review recommends clotting rate assays for routine use, while cautioning against prothrombin-time derived methods.

Area of Science:

  • Clinical Chemistry
  • Hematology
  • Coagulation Science

Background:

  • Fibrinogen is a key plasma protein for blood clotting, and low levels increase bleeding risk.
  • Elevated fibrinogen is an independent predictor of coronary heart disease events.
  • Fibrinogen functions as a positive acute-phase reactant protein.

Purpose of the Study:

  • To review current methods for measuring plasma fibrinogen.
  • To provide recommendations on the appropriate use of these fibrinogen assays.
  • To guide clinical practice in selecting the best fibrinogen measurement techniques.

Main Methods:

  • Review of available literature on fibrinogen measurement techniques.
  • Comparison of total clottable fibrinogen assays, clotting rate assays, prothrombin-time derived assays, and immunoassays.

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  • Evaluation of assay performance, clinical utility, and limitations.

    • Main Results:

    • Total clottable fibrinogen assays are definitive but time-consuming.
    • Clotting rate assays are recommended for routine investigation and monitoring of bleeding disorders.
    • Prothrombin-time derived assays show significant variability and are not recommended for routine use.
    • Immunoassays are useful for differentiating fibrinogen abnormalities and assessing cardiovascular risk.

    Conclusions:

    • Clotting rate assays are the preferred routine method for plasma fibrinogen measurement in clinical practice.
    • Prothrombin-time derived assays should be used with caution due to variability and discrepancies.
    • Immunoassays offer distinct advantages for specific diagnostic and risk assessment applications.