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DTIs and the Fibrinogen Assay

From “Gagee:”

Do you know if Dabigatran affects the fibrinogen levels like the other DTIs, argatroban, bivalirudin and lepirudin?

Hello. Yes, but it isn’t so much that the DTIs affect the fibrinogen level, it is that they prolong the thrombin time, upon which the Clauss fibrinogen assay is based, giving the illusion of reduced fibrinogen. If we want an accurate fibrinogen concentration while using DTIs, we have to perform a fibrinogen immunoassay. Since we are on the subject, please take a look at one of our newest audio modules, Thrombin Time Assay, which discusses the Clauss fibrinogen assay and the undervalued, but still occasionally useful, reptilase time. Geo

Comments (1)
May 16, 2011 7:24pm

So, should we add a “disclaimer” statement to our fibrinogen
So, should we add a “disclaimer” statement to our fibrinogen results that erroneously low results can be caused by DTI‘s?

That might be a good idea, Joe. I’d be inclined to suggest we use an immunoassay for the fibrinogen. I also recall Dave McGlasson saying the derived fibrinogen estimate, which several of the optical coagulometers report with every PT, is not affected by argatroban, lepirudin, or bivalirudin.

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