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Clot waveform analysis in Clauss fibrinogen assay contributes to classification of fibrinogen disorders

Atsuo Suzuki1, Nobuaki Suzuki2, Takeshi Kanematsu3

  • 1Department of Medical Technique, Nagoya University Hospital, Japan.

Thrombosis Research
|December 26, 2018
PubMed

Insights

Clot waveform analysis (CWA) of the Clauss fibrinogen assay (CFA) can differentiate fibrinogen disorders. Maximum coagulation velocity (Min1) serves as a fibrinogen antigen surrogate, enabling easier classification of these conditions.

Area of Science:

  • Hematology
  • Clinical Chemistry
  • Diagnostic Medicine

Background:

  • The Clauss fibrinogen assay (CFA) is a standard screening tool for fibrinogen disorders.
  • CFA measures functional fibrinogen activity (Ac) but cannot distinguish quantitative from qualitative defects without fibrinogen antigen (Ag) determination.
  • Accurate classification of fibrinogen disorders necessitates differentiating between reduced levels and impaired function.

Purpose of the Study:

  • To develop a novel method for classifying fibrinogen disorders using CFA.
  • To explore the utility of clot waveform analysis (CWA) parameters from CFA.
  • To identify a surrogate marker for fibrinogen antigen (Ag) within CFA data.

Main Methods:

  • CWA parameters were analyzed from CFA results of normal individuals (n=91) and patients with fibrinogen disorders (n=27).
  • Plasma samples were analyzed using a CS-5100 autoanalyzer.
  • Correlation between CWA parameters and fibrinogen antigen levels was investigated.

Main Results:

  • Maximum coagulation velocity (Min1) strongly correlated with fibrinogen Ag, serving as its surrogate.
  • The Ac/Min1 ratio differed significantly between normal individuals and those with hypofibrinogenemia or hypodysfibrinogenemia.
  • Estimated fibrinogen antigen (eAg) derived from Min1 allowed distinction between type I and type II deficiencies, with altered Ac/eAg ratios observed in dysfibrinogenemia and hypodysfibrinogenemia.

Conclusions:

  • CWA of CFA can effectively distinguish various fibrinogen disorders.
  • The combination of Ac/Min1 and Ac/eAg ratios provides a novel approach for qualitative detection of fibrinogen disorders.
  • This CWA-based method offers a simpler and potentially more accessible screening test for fibrinogen abnormalities.
Abstract

Keywords:
Clauss fibrinogen assayClot waveform analysisFibrinogen disordersLaboratory techniques

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