Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm.
OBJECTIVE
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.
Hosaka
Akihiro
A
Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
Miyata
Tetsuro
T
Aramoto
Haruo
H
Shigematsu
Hiroshi
H
Nakazawa
Tatsu
T
Okamoto
Hiroyuki
H
Shigematsu
Kunihiro
K
Nagawa
Hirokazu
H
D000368:Aged; D000990:Antithrombin III; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D016063:Blood Loss, Surgical; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D007841:Latex Fixation Tests; D008297:Male; D010447:Peptide Hydrolases / Q000097:blood
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C011468:fibrinmonomer; D000990:Antithrombin III; D010447:Peptide Hydrolases