Related Experiment Video
Updated: Jun 12, 2026

Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
Published on: June 4, 2020
Correlations between clot waveform analysis parameters and fibrinogen concentrations in cases with and without
Masatoshi Wakui1, Yuta Fujimori2, Shusaku Oka3
1Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
Background:
Clot waveform analysis (CWA) is performed to extend the interpretation of clotting reaction curves in activated partial thromboplastin time (APTT) or prothrombin time (PT) assays. The present study aims to investigate the relationship between CWA parameters and fibrinogen concentrations for elucidating how to use CWA for coagulation assessment.
Methods:
Data regarding APTT-CWA, PT-CWA, and fibrinogen measurements were analyzed from 83 different individuals with prolonged APTT or PT and from 145 different individuals with APTT and PT within their reference ranges. CWA was adjusted to cancel out the influence of fibrinogen.
Results:
The coefficient of variation (CV) was much lower in adjusted CWA parameters than in non-adjusted CWA parameters, concordant with canceling out the influence of fibrinogen concentrations. The CV in adjusted CWA parameters was higher in cases with prolonged APTT or PT compared to those with normal APTT and PT, likely due to the presence of various coagulopathies and anticoagulants. Regardless of APTT or PT data, non-adjusted CWA parameters and non-adjusted/adjusted CWA parameter ratios were positively correlated with fibrinogen concentrations. In APTT-CWA, the correlation coefficients of non-adjusted/adjusted CWA parameter ratios with fibrinogen concentrations were lower in cases of prolonged APTT or PT than in cases with normal APTT and PT, suggesting that other determinants than fibrinogen concentrations may alter turbidity changes and affect the CWA.
Conclusion:
The present study demonstrated correlations between CWA parameters and fibrinogen concentrations in clinical samples. The results are expected to help broaden the interpretation of clotting reaction curves in APTT and PT assays.
Related Concept Videos
Clot Retraction and Fibrinolysis
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Coagulation
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
Extrinsic and Intrinsic Pathways of Hemostasis
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
Venous Thrombosis III: Interprofessional Care

