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Fibrinogen function is impaired in whole blood from patients with cyanotic congenital heart disease

Jensen, A. S.; Johansson, P. I.; Bochsen, L.; Idorn, L.; Sorensen, K. E.; Thilén, Ulf LU ; Nagy, E.; Furenas, E. and Sondergaard, L. (2013) In International Journal of Cardiology 167(5). p.2210-2214
Abstract
Background: Patients with cyanotic congenital heart disease (CCHD) have haemostatic abnormities associated with bleeding and thrombo-embolic events. The haemostatic abnormalities are not fully understood, but recent studies indicate that elevated haematocrit and fibrinogen function may be of importance. The aim of this study was to characterise the haemostatic profile and examine the potential role of haematocrit on clot formation and strength in CCHD patients. Furthermore to examine whether CCHD patients with history of haemoptysis have diminished fibrinogen function compared to those without haemoptysis. Methods: In a prospective study 75 adult CCHD patients had haematocrit, platelet count, and plasma fibrinogen concentration examined.... (More)
Background: Patients with cyanotic congenital heart disease (CCHD) have haemostatic abnormities associated with bleeding and thrombo-embolic events. The haemostatic abnormalities are not fully understood, but recent studies indicate that elevated haematocrit and fibrinogen function may be of importance. The aim of this study was to characterise the haemostatic profile and examine the potential role of haematocrit on clot formation and strength in CCHD patients. Furthermore to examine whether CCHD patients with history of haemoptysis have diminished fibrinogen function compared to those without haemoptysis. Methods: In a prospective study 75 adult CCHD patients had haematocrit, platelet count, and plasma fibrinogen concentration examined. Furthermore thrombelastography(TEG) as well as TEG Functional Fibrinogen(TEG FF) assay evaluating fibrinogen function(FLEV) was performed. Data were compared with historical data regarding previous haemoptysis in CCHD patients. Results: Haematocrit was 57 +/- 8% and platelet counts in the lower normal range. TEG revealed a hypocoagulable condition with impaired clot formation. TEG values were correlated to haematocrit, indicating that elevated haematocrit causes impaired clot formation and strength. Despite high levels of plasma fibrinogen, TEG FF demonstrated that FLEV was diminished and negatively correlated to haematocrit. Furthermore CCHD patients with previous history of haemoptysis had significantly lower FLEV compared to CCHD patients without haemoptysis. Conclusion: Patients with CCHD are hypocoagulable mainly due to impaired fibrinogen function. Despite a low platelet count, platelet function does not seem to be severely affected in CCHD patients. Haemostasis, and especially fibrinogen function, is negatively affected by elevated haematocrit, and fibrinogen function is diminished in CCHD patients with haemoptysis. (C) 2012 Elsevier Ireland Ltd. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cyanotic congenital heart disease, Haemoptysis, Functional fibrinogen, Haematocrit, Thrombelastography
in
International Journal of Cardiology
volume
167
issue
5
pages
2210 - 2214
publisher
Elsevier
external identifiers
  • wos:000323569600096
  • scopus:84883288418
ISSN
0167-5273
DOI
10.1016/j.ijcard.2012.06.019
language
English
LU publication?
yes
id
8346087d-2f07-4104-b8aa-26f84bdb071a (old id 4062818)
date added to LUP
2014-03-03 08:11:05
date last changed
2019-02-20 01:36:29
@article{8346087d-2f07-4104-b8aa-26f84bdb071a,
  abstract     = {Background: Patients with cyanotic congenital heart disease (CCHD) have haemostatic abnormities associated with bleeding and thrombo-embolic events. The haemostatic abnormalities are not fully understood, but recent studies indicate that elevated haematocrit and fibrinogen function may be of importance. The aim of this study was to characterise the haemostatic profile and examine the potential role of haematocrit on clot formation and strength in CCHD patients. Furthermore to examine whether CCHD patients with history of haemoptysis have diminished fibrinogen function compared to those without haemoptysis. Methods: In a prospective study 75 adult CCHD patients had haematocrit, platelet count, and plasma fibrinogen concentration examined. Furthermore thrombelastography(TEG) as well as TEG Functional Fibrinogen(TEG FF) assay evaluating fibrinogen function(FLEV) was performed. Data were compared with historical data regarding previous haemoptysis in CCHD patients. Results: Haematocrit was 57 +/- 8% and platelet counts in the lower normal range. TEG revealed a hypocoagulable condition with impaired clot formation. TEG values were correlated to haematocrit, indicating that elevated haematocrit causes impaired clot formation and strength. Despite high levels of plasma fibrinogen, TEG FF demonstrated that FLEV was diminished and negatively correlated to haematocrit. Furthermore CCHD patients with previous history of haemoptysis had significantly lower FLEV compared to CCHD patients without haemoptysis. Conclusion: Patients with CCHD are hypocoagulable mainly due to impaired fibrinogen function. Despite a low platelet count, platelet function does not seem to be severely affected in CCHD patients. Haemostasis, and especially fibrinogen function, is negatively affected by elevated haematocrit, and fibrinogen function is diminished in CCHD patients with haemoptysis. (C) 2012 Elsevier Ireland Ltd. All rights reserved.},
  author       = {Jensen, A. S. and Johansson, P. I. and Bochsen, L. and Idorn, L. and Sorensen, K. E. and Thilén, Ulf and Nagy, E. and Furenas, E. and Sondergaard, L.},
  issn         = {0167-5273},
  keyword      = {Cyanotic congenital heart disease,Haemoptysis,Functional fibrinogen,Haematocrit,Thrombelastography},
  language     = {eng},
  number       = {5},
  pages        = {2210--2214},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Fibrinogen function is impaired in whole blood from patients with cyanotic congenital heart disease},
  url          = {http://dx.doi.org/10.1016/j.ijcard.2012.06.019},
  volume       = {167},
  year         = {2013},
}