Objective: To investigate the effect of heparin on fibrinogen detection by Clauss method. Methods: A normal plasma pool (NPP) of 20 healthy people was prepared with 3.2% sodium citrate anticoagulant. For experimental group 1, samples containing different concentrations of heparin were prepared. For experimental group 2, samples of experimental group 1 were diluted twice. For experimental group 3, samples of experimental group 1 were diluted 4 times. For the control group, samples of normal saline with the same volume as heparin in experimental group 1 were prepared. The fibrinogen contents of experimental group 1, experimental group 2, experimental group 3, and control group were detected by Clauss method and prothrombin time (PT)-derived method, and the fibrinogen detection results of different groups were analyzed. Results: The trend of fibrinogen detected by Clauss method and PT-derived method in experimental group 1 was different; there was significant difference between the results of experimental group 1 and the control group (P < 0.05); there was no significant difference between the results of experimental group 2 and the control group (P > 0.05); there was no significant difference between the results of experimental group 3 and the control group (P > 0.05); there was no significant difference between the results of experimental group 2 and experimental group 3 (P > 0.05); the relative deviation between experimental group 1 and the control group was higher in high-concentration heparin sample. Conclusion: Heparin affects fibrinogen detection by Clauss method, and the effect can be reduced by sample dilution.
Garcia DA, Baglin TP, Weitz JI, et al., 2012, Parenteral Anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th Ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest, 141(2): e24S–e43S. https://doi.org/10.1378/chest.11-2291
Mackie IJ, Kitchen S, Machin SJ, et al., 2003, Guidelines on Fibrinogen Assays. Br J Haematol, 121(3): 396–404.
Undas A, 2016, How to Assess Fibrinogen Levels and Fibrin Clot Properties in Clinical Practice?. Semin Thromb Hemost, 42(4): 381–388.
Chen Y, Huang L, Liu T, 2014, Analysis of the Status Quo of Laboratory Diagnosis of Hereditary Dysfibrinogenemia. Thrombosis and Hemostasis, 20(4): 194–198.
Zhang L, Yang J, Zheng X, et al., 2017, Influences of Argatroban on Five Fibrinogen Assays. Int J Lab Hematol, 39(6): 641–644. https://doi.org/10.1111/ijlh.12719
Miesbach W, Schenk J, Alesci S, et al., 2010, Comparison of the Fibrinogen Clauss Assay and the Fibrinogen PT Derived Method in Patients with Dysfibrinogenemia. Thromb Res, 126: e428–e433.
Shapiro SE, Phillips E, Manning RA, et al., 2013, Clinical Phenotype, Laboratory Features and Genotype of 35 Patients with Heritable Dysfibrinogenaemia. Br J Haematol, 160(2): 220–227. https://doi.org/10.1111/bjh.12085
Xiang L, Luo M, Yan J, et al., 2018, Combined Use of Clauss and Prothrombin Time Derived Methods for Determining Fibrinogen Concentrations: Screening for Congenital Dysfibrinogenemia. J Clin Lab Anal, 32(4): e22322. https://doi.org/10.1002/jcla.22322
Molinaro RJ, Szlam F, Levy JH, et al., 2008, Low Plasma Fibrinogen Levels with the Clauss Method During Anticoagulation with Bivalirudin. Anesthesiology, 109(1): 160–161.
Dager WE, Gosselin RC, Kitchen S, et al., 2012, Dabigatran Effects on the International Normalized Ratio, Activated Partial Thromboplastin Time, Thromboplastin Time, and Fibrinogen: A Multicenter, In Vitro Study. Ann Pharmacother, 46(12): 1627–1636.
Wang H, Zhao Y, Wang X, et al., 2018, Clinical Bleeding and Thrombotic Disorders, People’s Medical Publishing House, Beijing, 81–83.
Habib G, Lancellotti P, Antunes MJ, et al., 2015, 2015 ESC Guidelines for the Management of Infective Endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J, 36(44): 3075–3128. https://doi.org/10.1093/eurheartj/ehv319