Key result
Direct thrombin inhibitors falsely lower modified Clauss fibrinogen levels while ROTEM is less susceptible.
Why the study?
The effect of direct thrombin inhibitors on fibrinogen measurements using the modified Clauss method during bivalirudin anticoagulation was unclear.
Does bivalirudin and other direct thrombin inhibitors cause falsely low fibrinogen measurements when using the modified Clauss method?
Case Report (n=1)
No
Does bivalirudin and other direct thrombin inhibitors cause falsely low fibrinogen measurements when using the modified Clauss method?
Direct thrombin inhibitors like bivalirudin can cause falsely low fibrinogen levels when measured by the turbidimetric modified Clauss method, suggesting viscoelastic testing like ROTEM may be more reliable for monitoring.
No takes yet. Share an insight, caveat, or question.
May warrant caution interpreting Clauss fibrinogen on direct thrombin inhibitors; leaves open ROTEM validation in prospective studies.
Molinaro et al. (2008) conducted a case report in Acute myocardial infarction and heparin-induced thrombocytopenia (n=1). Direct thrombin inhibitors (bivalirudin, argatroban, lepirudin) vs. Baseline/unspiked plasma was evaluated on Fibrinogen measurements using the modified Clauss method vs ROTEM. Direct thrombin inhibitors, particularly argatroban and bivalirudin, falsely lower fibrinogen levels measured by the turbidimetric modified Clauss method, whereas ROTEM is less susceptible.
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