title: Clinical implication of plasma level of soluble fibrin monomer-fibrinogen complex in patients with abdominal aortic aneurysm.
abstract: 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.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, University of Tokyo, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hosaka
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miyata
authors.forename: Haruo
authors.initials: H
authors.lastname: Aramoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigematsu
authors.forename: Tatsu
authors.initials: T
authors.lastname: Nakazawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okamoto
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagawa
mesh_terms: 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
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C011468:fibrinmonomer; D000990:Antithrombin III; D010447:Peptide Hydrolases