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Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm.

AbstractOBJECTIVE:
We prospectively studied the clinical implication of plasma level of soluble fibrin monomer (FM)-fibrinogen complex, a recently established molecular marker reflecting thrombin activity, in patients with abdominal aortic aneurysm (AAA) undergoing elective aortic repair.
METHODS:
The study included 49 patients who underwent elective aneurysm repair using a gelatin-sealed or nonimpregnated Dacron prosthesis. Plasma level of soluble FM-fibrinogen complex was measured before surgery and on days 1, 3, 5, 7, and 10 postoperatively by latex agglutination assay utilizing monoclonal antibody IF-43. Plasma levels of thrombin-antithrombin complex (TAT), D-dimer, alpha2-plasmin inhibitor-plasmin complex (PIC), and fibrinogen were also evaluated.
RESULTS:
The preoperative level of soluble FM-fibrinogen complex showed variation in the degree of hemostatic activation, with fair correlations with TAT (r = 0.509, P < .001), D-dimer (r = 0.521, P < .001), and PIC (r = 0.579, P < .001). The patients with greater intraoperative blood loss (> or = 800 mL) showed a significantly elevated plasma level of soluble FM-fibrinogen complex preoperatively compared with those with less intraoperative blood loss (P = .009). Its postoperative fluctuation showed a similar pattern to that of TAT, reflecting the time course of coagulation activity. Gelatin impregnation of the Dacron vascular graft did not seem to influence the postoperative systemic coagulation mechanism.
CONCLUSIONS:
The results indicated that soluble FM-fibrinogen complex appears to be a useful diagnostic molecular marker to assess the activity of the coagulation system, and that its preoperative level may serve as a potential risk factor for intraoperative hemorrhagic diathesis in patients undergoing elective AAA repair.
AuthorsAkihiro Hosaka, Tetsuro Miyata, Haruo Aramoto, Hiroshi Shigematsu, Tatsu Nakazawa, Hiroyuki Okamoto, Kunihiro Shigematsu, Hirokazu Nagawa
JournalJournal of vascular surgery (J Vasc Surg) Vol. 42 Issue 2 Pg. 200-5 (Aug 2005) ISSN: 0741-5214 [Print] United States
PMID16102614 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • antithrombin III-protease complex
  • fibrin fragment D
  • fibrinmonomer
  • Antithrombin III
  • Peptide Hydrolases
Topics
  • Aged
  • Antithrombin III
  • Aortic Aneurysm, Abdominal (blood, surgery)
  • Biomarkers (blood)
  • Blood Loss, Surgical
  • Blood Vessel Prosthesis Implantation
  • Female
  • Fibrin Fibrinogen Degradation Products (analysis)
  • Humans
  • Latex Fixation Tests
  • Male
  • Peptide Hydrolases (blood)

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