Plasma viscosity, functional fibrinogen, and platelet reactivity in vascular surgery patients

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BACKGROUND: Platelet reactivity changes with shear stress, which in turn depends on whole blood and plasma viscosity (PV). Platelets interact with fibrinogen during thrombus formation, and fibrinogen is a determinant of PV. The respective role of PV and fibrinogen on platelet function is still unclear. METHODS: 30 patients undergoing vascular surgery were admitted to this study. In each patient we measured PV using a coneon- plate viscosimeter, functional fibrinogen using thromboelastometry, and platelet reactivity to thrombin receptor activating peptide (TRAP) stimulation using multi-electrode aggregometry. Routine coagulation parameter were measured. RESULTS: At the univariate analysis, platelet reactivity was positively associated with mean platelet volume (R2 = 0.15, P = 0.033) and PV (R2 = 0.35, P = 0.0006), and negatively associated with serum bilirubin (R2 = 0.20, P = 0.013) and international normalized ratio (INR) (R2 = 0.19, P = 0.017). At the multivariable analysis, only PV (P = 0.001) and INR (P = 0.019) remained independent predictors of platelet reactivity. CONCLUSION: PV is directly and independently associated with platelet reactivity, whereas functional fibrinogen is not. Aspirin treatment is inadequate to correct thrombin-induced platelet aggregation. In presence of hyperviscosity, patients at high cardiovascular risk, may benefit from more aggressive anti-platelet treatments.

Original languageEnglish
Pages (from-to)417-427
Number of pages11
JournalClinical Hemorheology and Microcirculation
Issue number3
Publication statusPublished - Jan 4 2016


  • Fibrinogen
  • Plasma viscosity
  • platelet reactivity
  • Thrombin

ASJC Scopus subject areas

  • Hematology
  • Physiology
  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine


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