Correlation of CRP and serum fibrinogen levels with disease severity, clinical factors and pulmonary function tests in COPD patients

Chronic obstructive pulmonary disease [COPD] is a progressive chronic disease and C-reactive protein [CRP] and fibrinogen are considered as main systemic inflammatory biomarkers. This study aimed to evaluate the alterations of CRP and serum fibrinogen levels in COPD patients and their correlation with the severity of disease, arterial O[2] saturation and opium or cigarette consumption. This was a descriptive case-control study conducted on 31 COPD patients and 29 healthy controls selected by using easy sampling method in Afzalipour Hospital. Serum levels of CRP and fibrinogen were measured by ELISA method and analyzed using SPSS software version 15. The mean serum level of CRP in the understudy patients [13.15 +/- 13.72 mg/L] was significantly higher than that of the controls [3.53 +/- 1.12 mg/L] [P=0.000]. However, no significant difference was found in the mean serum level of fibrinogen between cases [3.81 +/- 0.93 mg/dl] and controls [3.72 +/- 0.9 mg/dl] [p=0.82]. Also, no significant correlation was detected between the serum level of CRP or fibrinogen and severity of the disease [P=0.92 and P=0.58, respectively]. A statistically significant relationship was found between the serum levels of CRP and fibrinogen and arterial O[2] saturation [P=0.02]. There was no significant difference in the serum levels of CRP and fibrinogen between the opium users [p=0.19] and other patients [p=0.15]. According to our study results, COPD, per se, can increase the inflammatory biomarkers including CRP. Raised serum level of CRP is indicative of systemic inflammation which results in extra-pulmonary manifestations like cardiovascular diseases, cerebrovascular accidents, osteoporosis, and cachexia. Therefore, with routine measurement of this marker, we can evaluate the severity of systemic inflammation in these patients and choose the best treatment accordingly

Difficulties in the diagnosis of familial hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis [HLH] is characterized by proliferation and non-malignant activation of histiocytes and T lymphocytes in the reticuloendothelial system. Diagnostic guidelines include fever, splenomegaly, cytopenia, hypertriglyceridemia and / or hypofibrinogenemia with hemophagocytosis in the bone marrow, spleen or lymph nodes. In many patients diagnosis is difficult due to lack of diagnostic criteria, hemophagocytosis, variability of clinical presentation, spontaneous improvement and the absence of a specific marker of the disease. When there is strong clinical suspicion of familial hemophagocytic lymphohistiocytosis [FHL], chemotherapy and immunosuppressor treatment should be started early to achieve complete cure and should be followed by hematopoietic stem cell transplantation. We present a case of a 13 months old boy who presented with fever, anemia and thrombocytopenia, enlarged liver and spleen, hyperferritinemia, hypertriglyceridemia and hypertransaminasemia without the finding of hemophagocytosis in the bone marrow. The patient improved spontaneously but presented with reactivation of the disease six weeks later and died after few weeks

Comparing plasma level of CRP, factor VII, fibrinogen; platelet counts, systolic and diastolic blood pressure in smokers with opium addicted smokers

The observational and experimental studies show that there are more cases of cardiovascular disease especially myocardial infarction [MI] among addicts who are referred to hospitals compared with non-addicts. To determine some of cardiovascular risk factors in addict subjects. A total of 70 subjects aged 25-50 [35 smokers with opium addiction who were addict at least for last three years as case group and 35 smokers as control group] were selected. The plasma levels of factor VII, CRP, fibrinogen and blood platelet counts were determined for both groups. Also, the systolic and diastolic blood pressure was measured. The mean activity percent of plasma level for factor VII was significantly higher in opium addict men than control. The mean plasma level of fibrinogen in case group was lower than control but not significant. Also, no significant difference was observed between blood platelet counts among two groups. Mean plasma level of CRP was also significantly lower in addict group than the control group. Systolic and diastolic blood pressure was significantly lower in case group compared with control group [P<0.05]. The data found in our study showed that the blood factors such as plasma levels of factor VII and fibrinogen, as two cardiovascular risk factors, and also blood pressure were affected by opium addiction. It seems that one of the causes of higher numbers of MI among addict subjects to be likely associated with significantly greater values for factor VII activity seen in this population

Increased plasma fibrinogen concentration as a risk factor for ischemic heart disease

Thirty-seven patients [30 males and 7 females, aged 45-65 years] with coronary heart disease as well as 20 age- and sex-matched apparently healthy individuals as a reference group were participated in this study. Every patient was subjected to clinical evaluation including history taking and clinical examination with special stress on the presence of risk factors [e.g. smoking and hypertension], coronary angiography, and determination of fasting and post-prandial serum glucose, total cholesterol, low-density lipoprotein-c, high-density lipoprotein-c, triglycerides and determination of plasma fibrinogen levels. The aim of the present work was to assess the level and to evaluate the role of fibrinogen as a risk factor for coronary heart disease. Patients with coronary heart disease showed a statistically significant increase in plasma fibrinogen level [P < 0.001] when compared with the reference group. Coronary heart disease patients also showed statistically significant increase in fasting [P < 0.01], post-prandial serum glucose levels [P < 0.001], Low-density lipoprotein-c, triglycerides level [P < 0.001] and a statistically significant decrease in the serum levels of high-density lipoprotein-c [P < 0.001] when compared with the reference group. From these results, we concluded that the increased level of plasma fibrinogen is considered as a risk factor for the development of ischemic heart disease

Assessment of coagulation state in untreated hyperthyroid and hypothyroid patients

Several studies have reported varoius hemotatic abnormalities in patients with thyroid diseases the traditional associations between hypercoagulable state and hyperthyroidism and between hypocoagulative state and hypothyroidism are critically revised on the basis of more recent litrature data the purpose of this study was to asessment of coagulation state in terms of bleeding and thrombosis in untreated hyperthyroid and hypothroid patients the study was carried out in 60 patients [30 hyperthyroidism 30 hypothyroidism and 30 healthy subjects as ontrol group] blood samples were collected in Al Mowasah Hospital and Nuclear meicine center during 2004 the partial thromboplastin time PTT prothrombin time PT and fibrinogen were determined with a coagulometer uing commercial kits of human factors VIII and IX activity were measured with coagulometer using commercial diamed. TSH and FT4 were measured by an autimated chemiluminescence system [Tosoho Corporation JAPAN] all meaurements performed immediately in Nuclear Medicine Center Statistics were caculated by using T-test and Pearsons correlation coeffieent for results processing Factors VIII and IX activity were singnificantly increased in untreated hyperthyroid patients [144.03% p<0.05 122.93%, p<0.05 respectively] and factors VIII and IX activity were singnificantly decreased in untreated hypothyroid patients [90.68%, p<0.05, p<0.05, respectively] compared with the control group [120.68%, 96.36%, respectively]. Levels of fibrinogen were elevated significantly in untreated hyperthyroid and hypothyroid patients [292 mg/dl, p<0.05, 272,93mg/dl p<0.05 respectively] compared with the control group [252.76 mg/dl]. The classic coagulation status PTT and PT were not greatly altered in untreated hyperthyroid and hypothyroid patiets we did not find significant correlation between both FT4 and TSH levels and haemostatic parameters that we measured Hypercoagulable state were found in untreated hyperthyroid patients and increase risk for thromboembolism Hypocoagulable and hypercoagulable state were found in untreated hypothyroid patients and increased risk for thromboembolism and bleeding tendency these alterations were subclinical and could not have been detected with the routin coagulation test such as the PTT and PT that came in concordance with what Erem C. et al. 2003 about blood coagulation and fibrinolytic activity in hypothyroidism and Erem C et al. 2002 about blood coagulation and fibrinollysis in patients with hyperthyroidism therefore we must control the coagulability state in untreated hyperthyroid and hypothyroid patients

Es confiable determinar el fibrinógeno como derivado del tiempo de protrombina? / Is fibrinogen determination by prothrombine time derived method confidant?

Los niveles elevados de fibrógeno (Fbg) plasmático son considerados como un factor de riesgo para eventos trombóticos y enfermedad cardiovascular. El Fbg se cuantifica habitualmente utilizando el método coagulable de Clauss y el de Fbg derivado del tiempo de protrombina. A pesar de ser éste último, simple y económico, ha sido cuestionado en distintos estudios porque sobrestimaría los valores de Fbg. Para evaluar la confiabilidad de éste método, se lo comparó respecto al valor obtenido por el método de Clauss. Se evaluó, además, el efecto de la heparina (0,2 y 0,6 UI/ml) sobre las determinaciones por el método de Fbg derivado. La equivalencia entre ambos métodos se estableció por el test de Bland y Altman y el test de la Mediana. El efecto de la heparina se evaluó por regresión lineal y correlación de Pearson. Se puede concluir que los valores de Fbg por el método de Fbg derivado dentro de los rangos normales correlacionan con los obtenidos con el método de Clauss. Cuando éstos valores superan los 400 mg/dl debería determinarse el Fbg por el método de Clauss u otra metodología. Los valores obtenidos mediante el método de Fbg derivado no se modifican en muestras que contienen heparina en el rango terapéutico

Factores de riesgo causales, condicionales y predisponentes en coronarios del sur argentino: asociación con la presencia y severidad de las lesiones demostradas por angiografía / Causal, conditional and predisposing risk factors in coronary subjects of south argentina: association with the presence and severity of the lesions demostrated by angiography

El objetivo de éste estudio fue determinar, en sujetos coronarios de ésta región, los factores de riesgo más frecuentes, categorizados en causales, condicionales y predisponentes, asociados con la presencia y severidad de enfermedad coronaria, demostrada por angiografía, y analizar la asociación del índice Apo B/C-HDL con la presencia y severidad de las lesiones. Se estudiaron 90 pacientes de 36 a 70 años de edad (64 varones y 26 mujeres) del Servicio de Hemodinamia del Hospital Privado del Sur a quienes se les realizó una cinecoronarioangiografía. Se obtuvieron datos clínicos y bioquímicos de cada paciente. Se analizaron dos grupos: controles (N=26), angiografías sin anormalidades o estenosis < 50 por ciento en un vaso, y coronarios (N=64), estenosis >= 50 por ciento y lesiones de distinta severidad en uno o varios vasos. Los factores de riesgo más frecuentes en coronarios vs. controles fueron: causales: hiperlipoproteinemias tratadas (P < 0,0007), diabetes mellitus Tipo 2 (P < 0,001), C-HDL < 35 mg/dl (P=0,016), hipertensión arterial o tratados (P < 0,02), ex-fumadores > 10/día (P < 0,04). Predisponentes: historia familiar (P < 0,0007), índice de conicidad > 1,24 (P < 0,005). Los índices, Apo B/C-HDL > 2,6, CT/C-HDL > 4,5, C-LDL/C-HDL > 3,0, P= 0,0049, P= 0,011 y P= 0,022, respectivamente. Los predictores de presencia de la enfermedad fueron (por análisis de regresión logística múltiple), hiperlipoproteinemias tratadas, Apo B/C-HDL > 2,6 o ambas, la historia familiar y el índice de conicidad. Los predictores de severidad fueron: la diabetes, hiperlipoproteinemias tratadas, Apo B/C-HDL > 2,6 o ambas, ex-fumadores > 10/día y la historia familiar...

Fibrinogen titer and glycemic status in women using contraceptives

To assess the coagulation and glycemic status in Pakistani women using contraceptives. Design: The study was conducted prospectively on 70 women and compared with 10 age-matched controls. Place and Duration of Study: The study was conducted at Karachi. Period of study was 18 month. Subjects and Eighty women aged between 20-45 years selected from low socioeconomic class and poor family background were categorized in control [n=10] and oral and injectable contraceptive users [n=70]. The contraceptives used were tablet Lofemenal, injection Norigest and Norplant implant. Their blood was tested for fibrinogen titer and random blood glucose. There was no appreciable difference either in fibrinogen titer or plasma glucose levels in injectable users as compared to controls, but increased incidence of high fibrinogen titer and borderline blood glucose was observed in oral contraceptive users 25% and 20% respectively. It was concluded that long-term use of oral contraceptives [> 3 years] might increase the thrombotic tendency and elevate the plasma glucose levels especially in women above 30 years of age

Correlation of vitamin A, beta carotene and fibrinogen with other parameters in ischemic heart disease

Planned to find the He of biochemical parameters in the early diagnosis of IHD, 34 males and 36 females were taken with ischeamic heart disease. Results show that the level of total lipid, cholesterol and ration of chol/HDL-chol was increased, but the level of LDL, HDL-chol and triglyceride were decreased as compared to control subjects. No change in electrolytes level was observed. Level of enzymes like AST, CK-MB etc, were increased in patients. Renal function parameters were also increased. Levels of total proteine, albumin and carotene were decreased whereas the levels of globulin and vitamin A were increased in patients as compared to their controls. It is therefore concluded that in IHD not only enzyme and lipid metabolism is effected but it also shows that the constituent of lipoprotein like vitamin A and carotene level is changed. It was also observed that the severity of disease may effect on urea, creatinine and uric acid level resulting in the involvement of kidney

Cognitive function in patients with non valvular atrial fibrillation: correlation to markers of thrombogenesis

There is increasing evidence that non valvular atrial fibrillation NVAF is associated with an increased risk of asymptomatic or silent cerebral infarctions. An important question is whether these infarction are truly asymptomatic and whether anti-thrombotic treatment could be beneficial in those patients. In this study we examined components of cognitive function [Event Related Potentials "ERP[s]" P300 and Wechsler Adult Intelligence Scale "WAIS"] and markers of thrombogenesis [fibrinogen, fibrinopeptide A "FPA". platelet aggregation, platelet factor 4 "PF-4" and beta-thromboglobulin "beta T.G"] in 20 neurologically asymptomatic NVAF patients comparing them to a well matched group in sinus rhythm. In addition, parameters of cognitive function components were correlated to those of thrombogenesis in the group of AF patients. NVAF patients had significantly prolonged latency and significantly reduced amplitude of P300 component of ERPs in AF Vs sinus rhythm group respectively and significantly reduced verbal intelligence quotient [VIQ] component of [WAIS] Vs sinus rhythm group P< 0.006. In addition, NVAF patients had significantly elevated levels of fibrinogen [p< 0.01], FPA [p<0.001], significant platelet aggregation is response to 2 ug/ml collagen [p< 0.001] and 1 ug/ml collagen [P< 0.001] and significantly elevated levels of PF-4 [P< 0.01] and beta T. G [P< 0.001] compared to the group in sinus rhythm respectively. In the NVAF group, there was positive association between P300 latency of ERPs components and each of FPA and PF-4 with high P< 0.1 and marginal P= 0.05 significance respectively and significant inverse correlation between all parameters of WAIS components and those of thrombogenesis except for the relation of performance intelligence quotient [PIQ] to each of FPA and beta T.G levels. These results may aid in identifying those patients at high risk of developing dementia and may help decision making when anti thrombotic therapy is being considered in NVAF patients. We recommend cognitive

effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors

The possible consequences of the long intermittent fasting schedule during Ramadan [one month of food and water intake limited to night hours, a practice that is followed by the majority of the Muslims worldwide] on certain biochemical constituents or coagulation variables have not been extensively documented. Patients and During the month of Ramadan and two months after, we monitored the concentration of different plasma lipoproteins, lipoprotein [a] [Lp[a]], apoproteins A1 and B, fibrinogen, factor VII activity and some selected hematological factors in 50 healthy subjects who were employees of institutes related to the Isfahan University of Medical Sciences and aged between 30 and 45 years. The effect of fasting in Ramadan on the relationship between biochemical and coagulation variables was also investigated. The values of apoprotein B, Lp[a] and low-density lipoprotein cholesterol [LDL-C]/high-density lipoprotein cholesterol [HDL-C] ratio were significantly decreased during Ramadan [P<0.05], while total cholesterol [Tot-C], triglycerides [TG], LDL-C, HDL-C and fasting blood glucose did not change during that month. Among coagulation and hematological factors, fibrinogen level and factor VII activity were significantly decreased during the month [P<0.05]. Results also indicated a significant positive association between fibrinogen level and Lp[a], factor VII activity and Tot-C, LDL-C, TG and Apo B during Ramadan. Our findings contribute to a better understanding of previous reports, as the metabolic and coagulation changes that are considered as atherosclerosis risk factors are counterbalanced during Ramadan

relation between creatine kinase, magnesium and fibrinogen in patients with acute myocardial infarction

One of the most important mechanism of myocardial infarction is coronary thrombosis. One of the diagnostic procedures for myocardial infarction [MI] is serological tests to determine the levels of creatine kinase enzyme [CK] and, more effectively, creatine kinase MB isoenzyme [CK-MB]. On the other hand, high serum fibrinogen concentration can be considered as a risk factor for MI or the occurrence of complications after MI. The present study was conducted to find any possible relationship between the serum CK and CK-MB levels with serum magnesium and fibrinogen concentrations in acute MI [AMI], as well as any association between each of the factors mentioned with post-MI complications. The study included 100 MI affected patients [60 men and 40 women, between 30-60 years] hospitalized in the coronary care units [CCUs] of Isfahan hospitals in 1995. A questionnaire was completed for each subject to obtain information on personal characteristics, previous history of cardiovascular disease risk factors, MI type and location, radiological symptoms, prescribed medicines, and., in addition daily electrocardiography was performed for all patients. Also, blood samples were taken from each patient on admission, 6, 24 and 48 hours after MI for serum CK and CKMB measurements; the serum magnesium and fibrinogen concentrations were measured on the first and the second days, respectively. The results show that the peak value for CK enzyme and isoenzyme occurs 24 hours after MI. As regards the correlation between the serum magnesium and fibrinogen levels with the CK enzyme and CK-MB isoenzyme concentrations at different time points after MI, a significant correlation was observed only after 24 hours. The serum fibrinogen concentration was higher in men [366'103.7] than in women [311'105.2] [p=0.05]. On the other hand, the mean value of CK-MB isoenzyme was significantly higher in the Q-wave MI patients than in the non-Q-wave ones 6 and 24 hours after MI. In addition, there was a significant correlation between the CK enzyme and CKMB isoenzyme levels with post-MI complications after 24 hours. No correlation was found between serum magnesium and enzyme or the occurrence of MI complications were observed. It is concluded that only serum fibrinogen concentration can be used as a diagnostic serum marker for complicated MI

Newer metabolic risk factors for heart disease: a brief review

The classic risk factors for coronary heart disease [CHD] have included blood cholesterol level, arterial blood pressure and cigarette smoking, but these factors do not fully explain the occurrence of cardiovascular disease. Newer risk factors, particularly those with a metabolic origin, are now being considered in population studies. The major groupings for these factors include lipids, intermediary glucose metabolism, hematology and the vascular endothelium. Within the lipid group some of the factors included the impact of lipoprotein cholesterol fractions, lipoprotein [a] and the role of oxidized lipids. Diabetes mellitus is well-recognized as a risk factor for CHD and the impact of hyperglycemia, hyperinsulinemia, impaired glucose tolerance and glycosylated hemoglobin levels are being evaluated as potential risk factors. Hematologic factors under study include leucocyte count, fibrinogen, factor seven, von Willebrand' s antigen and fibrinolytic measures such as tPA antigen and plasminogen activator inhibitor [PAI-a]. Platelet count and activation also appear to be related to coronary disease occurrence and to the time of day at which coronary events occur. Processes that may affect the vascular endothelium include infectious agents and factors that may be toxic to endothelial surfaces, such as homocysteine. In the latter circumstance, higher levels of homocysteine appear to be associated with increased vascular disease and are associated with decreased levels of vitamins B6, B12 and folate. The overall impact of these newer cardiovascular risk factors and an assessment of genetic factors which may provide the underpinnings of their role is under active investigation and only population-based studies will provide proper evaluation of their importance

Effects of garlic [allium sativum] administration on: 2- some blood and hemostatic parameters in healthy male subjects

Garlic is a potent spice and medicine with broad therapeutic properties ranging from antibacterial to anticancer. Twenty two healthy male volunteers aged [35-50 years] comprising garlic administered group consumed 4-5 garlic cloves daily for 30 days [N = 14] and control group [N -8] participated in the study, to evaluate the effects of garlic administration on certain blood and hemostatic factors. Garlic ingestion resulted in significant reduction in platelets count, plasma fihrinogen level and longer prothrombin time. No changes in total and ionized calcium, hematocrit value, red blood cells count, serum total protein, albumin andferritin levels were noticed as effect of garlic ingestion. The findings suggest that garlic consumption may be benificial in diseases associated with platelets function, plasma fibrinoly tic activity and thrombosis

Study of plasma fibrinolytic activity in patients with systemic sclerosis

This work aimed to asses PFA in SSc as well as the extent of peripheral vascular involvement. Ten SSc and 10 healthy, age and sex matched controls were included in the study. After a detailed clinical examination and routine investigation, parameters of PFA; namely, ELT, fibrinogen level, plasminogen, and t-PA, were assessed. Doppler ultrasound examination of all peripheral vessels was carried out with determination of pressure, pressure gradients and ischemic ratios. Patients with SSc had low PFA evidenced by prolonged ELT, raised fibrinogen and plasminogen levels and low t-PA, peripheral ischemia in the form of low finger and toe pressures, high pressure gradients between wrist and fingers and between ankle and toes and low F/B and T/B ischemic ratios was demonstrated. Correlation studies revealed a positive correlation between prolonged ELT and raised fibrinogen level and between prolonged ELT and low t-PA. A positive correlation between a high Rodnan skin score and prolonged ELT, raised fibrinogen and low t-PA was also demonstrated. Positive correlation between radial to finger and ankle to toe pressure gradients and both prolonged ELT and low t-PA were also found. Reduced PFA and peripheral ischemia were demonstrated in SSc. Endothelial injury with reduction of t-PA could be responsible for reduced PFA. The resulting hyperviscosity caused by the hyperfibrinogenemia and fibrin deposits would produce the peripheral ischemia. A microvascular basis for fibrosis is also assumed

Some haematological studies on marshal in white rats

Forty rats were used to investigate the effects of marshal insecticide on hemogram, bone marrow and blood coagulation. Treated rats were fed on a ration containing 500 ppm marshal for 3 weeks. Blood and bone marrow samples were taken weekly and subjected to examination of RBCs and WBCs count, Hb concentration, PCV, platelet count, fibrinogen, PT and APTT. In addition to determination of M/E ratio in the bone marrow. The same tests were done in the control group. A marked decrease in RBCs count, Hb concentration and PCV was noted with development of microcytic hypochromic anaemia. Bone marrow showed a marked increase in the M/E ratio. A significant decrease in platelet count was recorded while fibrinogen values, PT and APTT were significantly increased throughout the experiment

Clinical significance of plasma fibrinogen level in acute myocardial infarction

Plasma fibrinogen and serum cardiac enzymes have been evaluated in patients with acute myocardial infarction. Our results showed that plasma fibrinogen and cardiac enzymes were significantly higher in patients with Q-wave myocardial infarction in comparison with non Q-wave infarction. Furthermore, plasma fibrinogen tended to be significantly higher in patients with complicated Q-wave infarction, and it showed a multimodal pattern in its values during the course of illness. We conclude that plasma fibrinogen can serve as a good diagnostic and prognostic parameter for Q-wave myocardial infarction