Supplemental Fibrinogen Restores Platelet Inhibitor-Induced Reduction in Thrombus Formation without Altering Platelet Function: An In Vitro Study
Research article published in Thrombosis and haemostasis (2020)
Abstract
BACKGROUND: For patients treated with dual antiplatelet therapy, standardized drug-specific 3-to-7 day cessation is recommended prior to major surgery to reach sufficient platelet function recovery. Here we investigated the hypothesis that supplemental fibrinogen might mitigate the inhibitory effects of antiplatelet therapy. METHODS AND RESULTS: To this end blood from healthy donors was treated in vitro with platelet inhibitors, and in vitro thrombus formation and platelet activation were assessed. Ticagrelor, acetylsalicylic acid, the combination of both, and tirofiban all markedly attenuated the formation of adherent thrombi, when whole blood was perfused through collagen-coated microchannels at physiological shear rates. Addition of fibrinogen restored in vitro thrombus formation in the presence of antiplatelet drugs and heparin. However, platelet activation, as investigated in assays of P-selectin expression and calcium flux, was not altered by fibrinogen supplementation. Most importantly, fibrinogen was able to restore in vitro thrombogenesis in patients on maintenance dual antiplatelet therapy after percutaneous coronary intervention. CONCLUSION: Thus, our in vitro data support the notion that supplementation of fibrinogen influences the perioperative hemostasis in patients undergoing surgery during antiplatelet therapy by promoting thrombogenesis without significantly interfering with platelet activation.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
For patients treated with dual antiplatelet therapy, standardized drug-specific 3-to-7 day cessation is recommended prior to major surgery to reach sufficient platelet function recovery.
Por qué esto importa para la hirudoterapia
Este estudio in vitro investigó si el fibrinógeno suplementario podía restaurar la formación de trombos en sangre completa de donantes sanos tratados con inhibidores plaquetarios (ticagrelor, ácido acetilsalicílico, tirofibán y combinaciones) más heparina, utilizando microcanales recubiertos de colágeno a velocidades de cizallamiento fisiológicas. El fibrinógeno restauró la trombogénesis sin alterar los marcadores de activación plaquetaria (P-selectina, flujo de calcio), y mostró efectos restauradores similares en pacientes en terapia antiplaquetaria dual de mantenimiento después de intervención coronaria percutánea. El resumen no menciona hirudina, componentes derivados de sanguijuelas ni sanguijuela terapéutica; la heparina —no la hirudina— es el anticoagulante estudiado, lo que hace que la relevancia de este artículo con el dominio de la ASH sea periférica en el mejor de los casos.
Citación
Supplemental Fibrinogen Restores Platelet Inhibitor-Induced Reduction in Thrombus Formation without Altering Platelet Function: An In Vitro Study
Brnthaler T et al. · Thrombosis and haemostasis, 2020
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Añadido a la biblioteca ASH: May 27, 2026 · Última actualización del sitio: 18 de junio de 2026