جستجوی مقالات مرتبط با کلیدواژه « fibrinogen » در نشریات گروه « پزشکی »

The role of activation of inflammatory processes in the exacerbation of COVID-19 disease has been fully confirmed. In addition, the occurrence of thromboembolic events in patients with COVID-19 is expected even long after recovery from the disease. However, which factors are essentially prognostic for this disease is still not theoretically agreed upon. What we did in the present study was to evaluate the prognostic role of some inflammatory and coagulation factors in predicting the severity of COVID-19 disease. In this study, the need for ICU admission was considered as a symbol of disease severity.
Forty-six cases were studied in this cross-sectional study. Patients over 18 years of age with a definitive diagnosis of COVID-19 were assessed in terms of coagulation profiles and inflammatory and cytokine markers. Regarding laboratory data, serum levels of D-dimer, protein S, protein C, FDP, and fibrinogen were measured using an automated coagulation analyzer, and serum levels of interleukin-6 were measured using the ELISA technique.
In total, 21 patients (45.7%) were admitted to the ICU due to the severity of the disease. In comparing inflammatory and coagulation factors between the two groups of patients, with and without ICU admission, a significant difference was revealed between fibrinogen (P=0.023), D-dimer (P=0.047), protein C (P=0.001), and protein S level (P=0.014). The decrease in protein C level had the highest value for predicting the severity of the disease and therefore the need for ICU admission.
Among various inflammatory and coagulation factors, the role of fibrinogen, D-dimer, protein C, and protein S in predicting the severe form of COVID-19 and the patient's need for ICU admission was confirmed.

Cardiovascular diseases are the leading cause of death in developing countries and hemorheological indices are the main factors in developing these diseases.

The main objective of this study was to investigate the impact of eight weeks of moderate intensity aerobic training combined with supplementation of aqueous extract of Cynodon dactylon L. Pers on hemorheological parameters in non-athletic young men.

A total of 40 young non-athletes (with a mean age of 35.63±6.43 years and a body mass index (BMI) of 23.55±2.13 kg/m2 ) were randomly assigned to one of four groups, including control (C), aerobic exercise (E), the C. dactylon extract (CD), and aerobic exercise+C. dactylon extract (E+CD). Changes in fibrinogen, blood and plasma viscosity, and hematocrit were measured at two stages (baseline and 24 hours after the intervention ended).

The blood fibrinogen level in three groups of E, CD, and E+CD showed a significant decline compared to the baseline status (P<0.05). Additionally, there were significant decreases in blood viscosity levels in groups E (P=0.006), CD (P=0.048), and E+CD (P=0.001) after eight weeks of intervention. The plasma viscosity also showed a significant reduction only in group E after eight weeks of intervention (P=0.004). Moreover, hematocrit level significantly decreased in group E+CD (P=0.018).

The findings of this study suggest that eight weeks of moderate intensity aerobic exercises alone and in combination with the consumption of the aqueous extract of C. dactylon L. Pers could improve hemorheological indices and reduce the risk of cardiovascular diseases.

 Hemorhological disorders are one of the primary causes of cardiovascular diseases. Accordingly, aerobic and combined exercises can improve hemorhological indicators and reduce cardiovascular complications in high-risk people.

 This study aimed to compare the effects of eight weeks of aerobic and combined exercise on some hemorheological indicators in middle-aged male patients undergoing Coronary Artery Bypass Graft Surgery.

 This experimental study was conducted in 2023 on 30 middle-aged men (Age, 57.63 ± 6.38, BMI, 26.61 ± 3.60) undergoing Coronary Artery Bypass Graft Surgery in Kermanshah, Iran, who were divided into aerobic (10 people), combined (10 people), and control (10 people) groups. The intervention groups received selected exercises for eight weeks (24 sessions). Serum hemoglobin, hematocrit, fibrinogen, and erythrocyte sedimentation rate (ESR) were measured before and after the intervention. The parametric paired sample t-test and one-way ANOVA test were used to examine differences at a significance level of P ≤ 0.05.

 The effect of combined exercises on hemoglobin and hematocrit was significant (P ≤ 0.05), but the amount of reduction in the aerobic group was not significant (P > 0.05). Findings in the fibrinogen and ESR variables showed a significant decrease in both aerobic and combined groups (P ≤ 0.05). There was no significant difference between the effect of eight weeks of aerobic and combined training on the variables of hemoglobin, hematocrit, fibrinogen, and ESR (P > 0.05).

 Based on the results, aerobic and combined exercises effectively improved the hemorheological indicators and overall conditions of patients who underwent Coronary Artery Bypass Graft Surgery. Therefore, these exercises should be included in the cardiac rehabilitation program as an effective treatment method.

It is known that the change in coagulation parameters has an effect on mortality and prognosis in COVID-19 patients. The SARS-CoV-2 virus has changed with mutations in the genome of the virus since the beginning of the pandemic, and the resulting variants have been recorded by the World Health Organization. With these variations, the clinical severity of the disease and laboratory parameters have also changed.

In this study, we examined the changes in D-dimer levels, fibrinogen levels, platelet count (PLT), and mean platelet volume (MPV) between SARS-CoV-2 Alpha (B.1.1.7), Beta (B.1.351) Delta (B.1.617.2), and Omicron (B.1.1.529) variants.

The study was conducted retrospectively on 28 195 adult patients with SARS-CoV-2 infection. At the time of application, data on age, gender, SARS-CoV-2 variant status, D-dimer levels (n = 7090), fibrinogen (n = 5709), PLT (n = 7066), and MPV (n = 8330) were collected. Patients were divided according to alpha, beta, delta, and omicron variants. The changes in variants were examined statistically.

The incidence of the delta variant in women was higher than the other variants, followed by alpha and omicron (P = 0.001). The Beta variant was detected at a higher rate in males. The ages of the cases with the Omicron variant were higher than the cases with Alpha, Beta, and Delta variants (P = 0.001, P = 0.001, P = 0.001, and P < 0.01, respectively). In laboratory parameters, D-dimer and fibrinogen levels were detected to be significantly higher in Delta and Omicron variants. PLT and MPV were determined to be lower in delta and omicron than in alpha and beta variants.

Examination of the changes in laboratory coagulation parameters according to variants shows that the tendency to clot increases from alpha to omicron.

The present study aimed to compare the levels of the inflammatory biomarkers of fibrinogen and highsensitivity C-reactive protein (hs-CRP) among type 2 diabetic patients treated with empagliflozin and other hypoglycemic drugs.

This cross-sectional study was performed on 90 patients with type 2 diabetes ( ≥ 30 years) receiving empagliflozin, metformin, and sulfonylurea who were referred to the diabetes clinics affiliated with Arak University of Medical Sciences. After obtaining consent to participate in the study, the patients were categorized into the treatment groups of metformin, metformin + empagliflozin, or metformin + sulfonylurea, and their characteristics and hypoglycemic drugs were recorded in the information checklist. The data were analyzed in SPSS 16 statistical software.

The fibrinogen level was minimized in the metformin + empagliflozin group, although the three groups were not significantly different in this regard (P = 0.382). Based on the results, the parameter was higher in the individuals with ischemic heart disease, while a lower level was found among those treated with a lipid-lowering agent. In terms of hs-CRP level, no statistically significant difference was observed among the three groups, although the metformin group had a lower level (P = 0.522).

The minimum fibrinogen and hs-CRP levels were related to the metformin + empagliflozin and metformin groups, respectively. Further, several factors such as comorbidities and other consumed drugs could affect the concentration of inflammatory factors. Thus, it is suggested that clinical trials should be conducted in this respect.

We read with interest the article titled "Prophylactic Fibrinogen Reduces Excessive Bleeding in Total Hip Arthroplasty Surgery: A Randomized Double-blinded Placebo-controlled Trial" authored by Alireza Shakeri et al. with great interest. We commend the authors for their efforts to demonstrate the hemostatic effect of fibrinogen in total hip arthroplasty. However, we are concerned about the lack of clear criteria for postoperative blood transfusion in patients undergoing total hip arthroplasty, a crucial aspect that significantly influences the methodology of this study.

Excessive blood loss is a critical complication of total hip arthroplasty. We intended to determine whether preoperative fibrinogen administration reduces perioperative bleeding and the need for blood transfusion in total hip arthroplasty surgery. In 4 months, 178 patients who underwent total hip arthroplasty were randomly assigned equally to intervention and placebo-control groups in a double-blinded, parallel two-arm randomized controlled trial. Both intravenously, 30 min before the start of the surgery, the intervention group received two grams of fibrinogen concentrate dissolved in 100 ml of distilled water. In contrast, the control group received 100 ml of normal saline solution. The amount of postoperative blood loss served as the main result, and the requirement for blood transfusions served as the secondary outcome. In comparison to the placebo, administering fibrinogen concentrate considerably reduced the amount of blood loss (P=0.001) and the requirement for blood transfusions (P=0.004). Patients who got fibrinogen concentrate experienced no side effects. In addition, patients in the fibrinogen group had significantly lower hemoglobin and higher fibrinogen levels in the recovery room and received lesser blood transfusions (P<0.005) than the placebo group. In total hip arthroplasty, fibrinogen concentrate lessens postoperative bleeding and the requirement for blood transfusions. Level of evidence: II

Postpartum hemorrhage is the most common cause of maternal morbidity and mortality, which can occur unexpectedly without warning, and without any underlying causes. We hypothesized that administering fibrinogen concentrate to cesarean section patients before surgery would reduce perioperative blood loss.

In this double-blind randomized controlled parallel group study, a single dosage of fibrinogen concentrate or a placebo was given to 260 cesarean section patients at random (by G*Power software, Heinrich-Heine-Universität Düsseldorf, Germany) in a university-affiliated general hospital between November 11, 2022, to January 8, 2023. Individuals in the fibrinogen group received a dose of one gram of fibrinogen concentrate and those in the placebo group received normal saline solution with the same volume in the placebo group. Total blood loss was the primary outcome of this study.

A total of 280 cases were screened and 260 were randomized. With a P-value of 0.001, the median (IQR) volume of bleeding in the fibrinogen group was 660 (341.25) mL, as opposed to 790 (475.00) mL in the placebo group. Comparatively, only 10 (7.7%) of the fibrinogen group and 26 (20%) of the placebo group required blood transfusions (P=0.006). No adverse event related to fibrinogen was reported.

Empiric treatment with fibrinogen concentrate results in reduced blood loss.

Delayed diagnosis and treatment of postpartum hemorrhage could result in mortality. Today, there is a strong desire to determine the factors affecting postpartum hemorrhage, particularly fibrinogen levels. This study aimed to investigate the role of plasma fibrinogen levels in postpartum hemorrhage and severe postpartum hemorrhage. This cross-sectional study was conducted on 169 term pregnant women who were candidates for an elective Cesarean section. Fibrinogen and other coagulating factors were measured before and at the end of the surgery, and twenty-four hours after surgery. Bleeding volume was also measured during and at the end of the surgery, and twenty-four hours after that. The relationship between coagulation factors and the amount of bleeding was examined using statistical tests. Mean plasma fibrinogen levels measured before, at the end of, and 24 hours after surgery were 247.65±91.07 mg/dl, 219.4±75.60 mg/dl, and 223.91±65.44 mg/dl, respectively. Sixty-five patients (38.5%) had postpartum hemorrhage (1000-2000mL) and seven patients (4.1%) had severe postpartum hemorrhage (>2000mL). Of the cases with preoperative fibrinogen levels less than 200mg/dl, 72% had postpartum hemorrhage and 14% had the severe form. There was a strong association between the patient's plasma fibrinogen level with PPH and sPPH (P=0.000). This study showed a strong correlation between plasma fibrinogen levels and postpartum hemorrhage and severe postpartum hemorrhage. In addition, it has been shown that low plasma fibrinogen levels could be a direct prognostic factor for postpartum hemorrhage and severe postpartum hemorrhage. Younger women and preoperative anemia were other strong predictors.

Orthopedic surgeries are frequently complicated with a high amount of intra-operative hemorrhage, and this bleeding has a direct effect on the results of these operations.

This study evaluated the effect of preoperative administration of fibrinogen on intraoperative bleeding in pelvic surgeries.

This study was a double-blinded, randomized clinical trial. Forty-two patients were randomly divided into two groups of fibrinogen and placebo. Hemoglobin, platelet, and fibrinogen levels were measured in all patients before surgery. In the intervention group, the patients received 1 gr. of fibrinogen after the induction of anesthesia. In the control group, the patients received the same volume of normal saline. All data on bleeding, transfused blood, blood pressure, duration of surgery, hemoglobin, platelet, and fibrinogen levels were recorded during a 24-hour period after surgery.

There was no significant difference in terms of age and sex between the groups (P > 0.05). There was no significant difference between hemoglobin, blood transfusion rate, international normalization ratio (INR), prothrombin time (PT), and partial thromboplastin time (PTT) in the two study groups (P> 0.05). Patients’ bleeding rate was significantly lower in the fibrinogen group (1328.57 ± 227.8 mL) than in the placebo group (1610 ± 479.58 mL) (P < 0.05). However, there was no significant difference between serum levels of fibrinogen before and after surgery in both groups (P > 0.05).

Although prophylactic injection of fibrinogen did not decrease the rate of blood transfusion to the patients in pelvic surgeries, it resulted in a significant bleeding reduction.

COVID-19 infection can be complicated by coagulation derangement and a high risk of thromboembolic episodes. Our study aimed to investigate coagulation parameters in COVID-19 patients and their correlation with clinical severity.

We analyzed coagulation parameters PT, APTT, D-Dimer, and Fibrinogen in 98 RT-PCR-confirmed COVID-19 patients admitted to the Government Institute of Medical Sciences, Gautam Buddha Nagar, Uttar Pradesh, India.

This study involved 69 males (70.50%), and 29 (29.5%) were females. The mortality rate was 6.12% (n= 06). Forty-six patients (46.94%) had comorbidities. Thirty-four patients had elevated PT, and 7 had high APTT, whereas D-dimer and fibrinogen levels were raised in 68 and 61 patients, respectively. Among all four parameters, D-Dimer levels were significantly associated with disease severity.

Derangement of D-dimer levels is significantly associated with disease severity in COVID-19 infection.

The present study investigated the plasma level of fibrinogen before and after removing the pump in coronary artery bypass graft (CABG) surgery and its relationship with the need for blood products.

The present study was performed on 60 patients who were candidates for CABG surgery. The fibrinogen level of these patients was assessed and recorded before surgery and immediately after removing the pump. In addition, their hemoglobin level was recorded before the operation and 2 h after. In addition, the number and type of blood products transfusion were recorded intraoperatively and postoperatively and also at the intensive care unit.

Patients’ fibrinogen level after removing the pump with the mean of 130.53 ± 122.01 mg/dl decreased significantly compared to before surgery with the mean of mg/dl 224.95 ± 132.88 mg/dl (P < 0.001). In addition, the prognostic value of fibrinogen after removing the pump in determining the postoperative need of blood transfusion showed that the cut‑off value of fibrinogen was < 196 mg/dl with a sensitivity of 16.82% and specificity of 80%, but it was not statistically significant (area under the curve [95% confidence interval]: 0.519 [0.350–0.689]; P = 0.825).

According to the results of the present study, due to significant changes in fibrinogen levels after removing the pump compared to preoperation, it seems that this factor can play an important role in prognosis of the need to postoperative blood transfusion, although the prognostic value and the critical point mentioned in our study was not significant and it is required to do further studies

Coronary stenosis and ectasia are cardiovascular diseases characterized by dysfunction of endothelial cells. Studies have shown that impaired blood flow due to inflammation and deposition in the endothelial cell wall can be effective in disease occurrence and progression. Although the etiologies of these diseases have not been identified accurately, it has been shown that inflammation and coagulation can be the main causes in these patients.

The aim of this study was to evaluate the levels of fibrinogen, Interlukine-17A (IL-17A), and red distribution width (RDW) in patients with coronary artery disease (CAD) and ectasia.

In this study, 140 patients with CAD admitted to Shariati Hospital of Tehran University of Medical Sciences, Iran, were included from from Jun 2020 to October 2021. Based on the severity of CAD, the participants were divided into two equal groups (n = 70 in each) of mild CAD (patients with CAD less than 50%) and multi-vessels CAD (patients with more than 50% stenosis in coronary arteries) according to the number of involved vessels (one, two, or three). Then, 5 cc of peripheral blood was collected from each patient in ethylenediaminetetraacetic acid (EDTA) containing tubes. IL-17A and fibrinogen were measured using enzyme-linked immunosorbent assay (ELISA) kit, and RDW was calculated by cell counter.

The mean age of participants was 63.0 ± 11.0 years in the mild group (35% males vs. 65% females) and 60.1 ± 12.1 years in the multi-vessels group (28% males vs. 72% females). The results showed that IL-17A, fibrinogen, and RDW levels in patients with ectasia and multi-vessels group were significantly higher than those in patients without coronary ectasia and mild CAD, respectively (P-value = 0.01 for fibrinogen; P-value = 0.05 for IL-17A; and P-value = 0.03 for RDW).

According to our results, identification and evaluation of fibrinogen and IL-17A, along with laboratory indices including RDW can be helpful in diagnosing high-risk individuals. Ectasia can be prevented, and it is possible to increase the patients’ survival through using some preventive and therapeutic strategies.