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Correlations between clot waveform analysis parameters and fibrinogen concentrations in cases with and without prolonged activated partial thromboplastin time or prothrombin time.

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Τίτλος: Correlations between clot waveform analysis parameters and fibrinogen concentrations in cases with and without prolonged activated partial thromboplastin time or prothrombin time.
Συγγραφείς: Wakui M; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan. Electronic address: wakuism@keio.jp., Fujimori Y; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Oka S; Clinical Laboratory, Keio University Hospital, Tokyo, Japan; Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan., Nakagawa T; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Nakamura S; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Ozaki Y; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Kurafuji Y; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Yatabe Y; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Ziparo M; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan; School of Clinical Pathology and Clinical Biochemistry, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy., Arai T; Clinical Laboratory, Keio University Hospital, Tokyo, Japan., Haniu H; Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan; Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, Matsumoto, Japan., Matsushita H; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
Πηγή: Clinica chimica acta; international journal of clinical chemistry [Clin Chim Acta] 2026 Sep 15; Vol. 591, pp. 121163. Date of Electronic Publication: 2026 Jun 10.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 1302422 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-3492 (Electronic) Linking ISSN: 00098981 NLM ISO Abbreviation: Clin Chim Acta Subsets: MEDLINE
Imprint Name(s): Original Publication: Amsterdam, Elsevier.
Ιατρικοί όροι (MeSH): Fibrinogen*/analysis , Prothrombin Time* , Blood Coagulation*, Humans ; Partial Thromboplastin Time ; Female ; Blood Coagulation Tests
Περίληψη: Background: Clot waveform analysis (CWA) is performed to extend the interpretation of clotting reaction curves in activated partial thromboplastin time (APTT) or prothrombin time (PT) assays. The present study aims to investigate the relationship between CWA parameters and fibrinogen concentrations for elucidating how to use CWA for coagulation assessment.
Methods: Data regarding APTT-CWA, PT-CWA, and fibrinogen measurements were analyzed from 83 different individuals with prolonged APTT or PT and from 145 different individuals with APTT and PT within their reference ranges. CWA was adjusted to cancel out the influence of fibrinogen.
Results: The coefficient of variation (CV) was much lower in adjusted CWA parameters than in non-adjusted CWA parameters, concordant with canceling out the influence of fibrinogen concentrations. The CV in adjusted CWA parameters was higher in cases with prolonged APTT or PT compared to those with normal APTT and PT, likely due to the presence of various coagulopathies and anticoagulants. Regardless of APTT or PT data, non-adjusted CWA parameters and non-adjusted/adjusted CWA parameter ratios were positively correlated with fibrinogen concentrations. In APTT-CWA, the correlation coefficients of non-adjusted/adjusted CWA parameter ratios with fibrinogen concentrations were lower in cases of prolonged APTT or PT than in cases with normal APTT and PT, suggesting that other determinants than fibrinogen concentrations may alter turbidity changes and affect the CWA.
Conclusion: The present study demonstrated correlations between CWA parameters and fibrinogen concentrations in clinical samples. The results are expected to help broaden the interpretation of clotting reaction curves in APTT and PT assays.
(Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Activated partial thromboplastin time; Adjusted clot waveform analysis; Comprehensive coagulation assessment; Fibrinogen; Non-adjusted clot waveform analysis; Prothrombin time
Substance Nomenclature: 9001-32-5 (Fibrinogen)
Entry Date(s): Date Created: 20260610 Date Completed: 20260811 Latest Revision: 20260811
Update Code: 20260812
DOI: 10.1016/j.cca.2026.121163
PMID: 42269739
Βάση Δεδομένων: MEDLINE
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  Data: Correlations between clot waveform analysis parameters and fibrinogen concentrations in cases with and without prolonged activated partial thromboplastin time or prothrombin time.
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  Data: <searchLink fieldCode="AU" term="%22Wakui+M%22">Wakui M</searchLink>; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan. Electronic address: wakuism@keio.jp.<br /><searchLink fieldCode="AU" term="%22Fujimori+Y%22">Fujimori Y</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Oka+S%22">Oka S</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan; Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan.<br /><searchLink fieldCode="AU" term="%22Nakagawa+T%22">Nakagawa T</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Nakamura+S%22">Nakamura S</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Ozaki+Y%22">Ozaki Y</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Kurafuji+Y%22">Kurafuji Y</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Yatabe+Y%22">Yatabe Y</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Ziparo+M%22">Ziparo M</searchLink>; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan; School of Clinical Pathology and Clinical Biochemistry, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.<br /><searchLink fieldCode="AU" term="%22Arai+T%22">Arai T</searchLink>; Clinical Laboratory, Keio University Hospital, Tokyo, Japan.<br /><searchLink fieldCode="AU" term="%22Haniu+H%22">Haniu H</searchLink>; Biomedical Engineering Division, Graduate School of Medicine, Science and Technology, Shinshu University, Matsumoto, Japan; Institute for Biomedical Sciences, Interdisciplinary Cluster for Cutting Edge Research, Shinshu University, Matsumoto, Japan.<br /><searchLink fieldCode="AU" term="%22Matsushita+H%22">Matsushita H</searchLink>; Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Elsevier%22">Elsevier </searchLink><i>Country of Publication: </i>Netherlands <i>NLM ID: </i>1302422 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1873-3492 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2200098981%22">00098981 </searchLink><i>NLM ISO Abbreviation: </i>Clin Chim Acta <i>Subsets: </i>MEDLINE
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  Data: <searchLink fieldCode="MM" term="%22Fibrinogen%22">Fibrinogen*</searchLink>/<searchLink fieldCode="MM" term="%22Fibrinogen+analysis%22">analysis</searchLink> <br /><searchLink fieldCode="MM" term="%22Prothrombin+Time%22">Prothrombin Time*</searchLink> <br /><searchLink fieldCode="MM" term="%22Blood+Coagulation%22">Blood Coagulation*</searchLink><br /><searchLink fieldCode="MH" term="%22Humans%22">Humans</searchLink> ; <searchLink fieldCode="MH" term="%22Partial+Thromboplastin+Time%22">Partial Thromboplastin Time</searchLink> ; <searchLink fieldCode="MH" term="%22Female%22">Female</searchLink> ; <searchLink fieldCode="MH" term="%22Blood+Coagulation+Tests%22">Blood Coagulation Tests</searchLink>
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  Label: Abstract
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  Data: Background: Clot waveform analysis (CWA) is performed to extend the interpretation of clotting reaction curves in activated partial thromboplastin time (APTT) or prothrombin time (PT) assays. The present study aims to investigate the relationship between CWA parameters and fibrinogen concentrations for elucidating how to use CWA for coagulation assessment.<br />Methods: Data regarding APTT-CWA, PT-CWA, and fibrinogen measurements were analyzed from 83 different individuals with prolonged APTT or PT and from 145 different individuals with APTT and PT within their reference ranges. CWA was adjusted to cancel out the influence of fibrinogen.<br />Results: The coefficient of variation (CV) was much lower in adjusted CWA parameters than in non-adjusted CWA parameters, concordant with canceling out the influence of fibrinogen concentrations. The CV in adjusted CWA parameters was higher in cases with prolonged APTT or PT compared to those with normal APTT and PT, likely due to the presence of various coagulopathies and anticoagulants. Regardless of APTT or PT data, non-adjusted CWA parameters and non-adjusted/adjusted CWA parameter ratios were positively correlated with fibrinogen concentrations. In APTT-CWA, the correlation coefficients of non-adjusted/adjusted CWA parameter ratios with fibrinogen concentrations were lower in cases of prolonged APTT or PT than in cases with normal APTT and PT, suggesting that other determinants than fibrinogen concentrations may alter turbidity changes and affect the CWA.<br />Conclusion: The present study demonstrated correlations between CWA parameters and fibrinogen concentrations in clinical samples. The results are expected to help broaden the interpretation of clotting reaction curves in APTT and PT assays.<br /> (Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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  Data: <i>Keywords: </i>Activated partial thromboplastin time; Adjusted clot waveform analysis; Comprehensive coagulation assessment; Fibrinogen; Non-adjusted clot waveform analysis; Prothrombin time
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