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Fibrinogen levels are associated with bleeding in patients with primary immune thrombocytopenia.
Platelets 2019; :1-8P

Abstract

Bleeding is the most common clinical symptom and the leading cause of death in patients with primary immune thrombocytopenia (ITP). Our research intends to verify the role of fibrinogen levels as independent determinants of bleeding. We retrospectively analyzed the relationship between fibrinogen levels and bleeding events in 463 patients. Additionally, we confirmed the impact of fibrinogen level on clot firmness in 25 patients via thrombelastography (TEG). Fibrinogen levels (median and inter-quartile range, IQR) were significantly different (p < .001) between bleeding and non-bleeding patients [258(207-314) mg/dL vs. 315(262-407) mg/dL, respectively]. Further analyzes in three subgroups based on platelet (PLT) count showed that non-bleeding patients still had higher fibrinogen levels than bleeding patients. The optimal discriminant threshold of fibrinogen in bleeding was 288.5 mg/dL according to receiver operating characteristic (ROC) curves. Patients were divided into low (LF, 230[193-258] mg/dL) and high (HF, 349[313-424] mg/dL) fibrinogen groups based on this threshold. Bleeding event rates were significantly different (LF: 84.6% vs. HF: 60.4%, P < .001) between the two groups. Multivariable analyses further confirmed these differences. Moreover, TEG parameters showed elevated clot firmness in the HF group. Our data suggest that high fibrinogen levels are associated with reduced bleeding events.

Authors+Show Affiliations

Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China.Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China.Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China.Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China.Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China. Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology , Wuhan , Hubei , China.Institute of Haematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan , Hubei , China. Collaborative Innovation Center of Hematology, Huazhong University of Science and Technology , Wuhan , Hubei , China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31610686

Citation

Xu, Min, et al. "Fibrinogen Levels Are Associated With Bleeding in Patients With Primary Immune Thrombocytopenia." Platelets, 2019, pp. 1-8.
Xu M, Luo L, Du M, et al. Fibrinogen levels are associated with bleeding in patients with primary immune thrombocytopenia. Platelets. 2019.
Xu, M., Luo, L., Du, M., Tang, L., Hu, Y., & Mei, H. (2019). Fibrinogen levels are associated with bleeding in patients with primary immune thrombocytopenia. Platelets, pp. 1-8. doi:10.1080/09537104.2019.1678115.
Xu M, et al. Fibrinogen Levels Are Associated With Bleeding in Patients With Primary Immune Thrombocytopenia. Platelets. 2019 Oct 15;1-8. PubMed PMID: 31610686.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibrinogen levels are associated with bleeding in patients with primary immune thrombocytopenia. AU - Xu,Min, AU - Luo,Lili, AU - Du,Mengyi, AU - Tang,Lu, AU - Hu,Yu, AU - Mei,Heng, Y1 - 2019/10/15/ PY - 2019/10/16/pubmed PY - 2019/10/16/medline PY - 2019/10/16/entrez KW - Bleeding KW - fibrinogen KW - platelet KW - primary immune thrombocytopenia KW - thrombocytopenia SP - 1 EP - 8 JF - Platelets JO - Platelets N2 - Bleeding is the most common clinical symptom and the leading cause of death in patients with primary immune thrombocytopenia (ITP). Our research intends to verify the role of fibrinogen levels as independent determinants of bleeding. We retrospectively analyzed the relationship between fibrinogen levels and bleeding events in 463 patients. Additionally, we confirmed the impact of fibrinogen level on clot firmness in 25 patients via thrombelastography (TEG). Fibrinogen levels (median and inter-quartile range, IQR) were significantly different (p < .001) between bleeding and non-bleeding patients [258(207-314) mg/dL vs. 315(262-407) mg/dL, respectively]. Further analyzes in three subgroups based on platelet (PLT) count showed that non-bleeding patients still had higher fibrinogen levels than bleeding patients. The optimal discriminant threshold of fibrinogen in bleeding was 288.5 mg/dL according to receiver operating characteristic (ROC) curves. Patients were divided into low (LF, 230[193-258] mg/dL) and high (HF, 349[313-424] mg/dL) fibrinogen groups based on this threshold. Bleeding event rates were significantly different (LF: 84.6% vs. HF: 60.4%, P < .001) between the two groups. Multivariable analyses further confirmed these differences. Moreover, TEG parameters showed elevated clot firmness in the HF group. Our data suggest that high fibrinogen levels are associated with reduced bleeding events. SN - 1369-1635 UR - https://www.unboundmedicine.com/medline/citation/31610686/Fibrinogen_levels_are_associated_with_bleeding_in_patients_with_primary_immune_thrombocytopenia L2 - http://www.tandfonline.com/doi/full/10.1080/09537104.2019.1678115 DB - PRIME DP - Unbound Medicine ER -