γ′ fibrinogen levels are associated with blood clot strength in traumatic brain injury patients

Abstract

© 2020 Elsevier Inc. Background: γ′ fibrinogen is an alternatively-spliced fibrinogen variant that displays different coagulation parameters in vitro than the major form of fibrinogen. Purified γ′ fibrinogen has slower clotting kinetics than unfractionated fibrinogen, but forms clots that are stronger and resistant to fibrinolysis. However, these properties have only been investigated in human populations in a limited number of studies. We therefore performed a retrospective analysis to test the hypothesis that γ′ fibrinogen levels influence coagulation in vivo. Methods: In the present study, we utilized blood samples that were collected from traumatic brain injury patients to probe the relationship between γ′ fibrinogen levels and traditional coagulation parameters. Results: The results show that the levels of γ′ fibrinogen were inversely associated with clotting kinetics, indicated by a shortened INR. In addition, the levels of γ′ fibrinogen were associated with stronger clots by thrombelastography. However, these changes were not associated with significant changes in hemorrhage progression. Conclusions: These findings verify that γ′ fibrinogen properties observed in purified systems result in similar properties in a clinical setting, and may affect coagulation.