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Original Research

Open Access

Evaluation of fibrinogen function by CFF-A10 in cardiac surgery

  • Minako Furuta1
  • Hisakatsu Ito2,*,
  • Shota Sakai2
  • Daisuke Hibi2
  • Mitsuaki Yamazaki3

1Department of Anesthesiology, Toyama Prefectural Central Hospital, 930-8550 Toyama, Japan

2Department of Anesthesiology, Toyama University Hospital, 930-0194 Toyama, Japan

3Department of Anesthesiology, Toyama Nishi General Hospital, 939-2716 Toyama, Japan

DOI: 10.22514/sv.2023.072 Vol.19,Issue 6,November 2023 pp.52-59

Submitted: 03 January 2023 Accepted: 14 February 2023

Published: 08 November 2023

*Corresponding Author(s): Hisakatsu Ito E-mail:


Fibrinogen function is evaluated as the maximum amplitude (MA) of the citrated functional fibrinogen (CFF) assay in TEG6s®, however, CFF-MA requires a long time to obtain results. CFF-A10 (10-minute value), allowing more rapid decisions, however, no studies have evaluated the correlation between CFF-A10 levels and fibrinogen concentration. This study aimed to assess the correlation between CFF-A10 and blood fibrinogen levels measured using the dry hematology method after cardiopulmonary bypass (CPB). This retrospective study was conducted in a single university hospital and enrolled 192 patients of all ages who underwent cardiovascular surgery with CPB between 01 March 2020, and 05 November 2021. CFF-A10 and CFF-MA levels were measured using the TEG6s® global hemostasis assay, and blood fibrinogen levels were measured using the Fibcare® DRIHEMATO Fib-HSII after CPB. Simple linear regression analysis was used to evaluate the relationship between TEG6s® parameters and fibrinogen concentration. Furthermore, the patients were classified into four groups based on the cut-off values of fibrinogen at 150 mg/dL and CFF-A10, and the background factors for each group were analyzed. CFF-A10 and blood fibrinogen levels were correlated by linear regression (p < 0.0001, R2 = 0.37), similar to CFF-MA and fibrinogen levels (p < 0.0001, R2 = 0.40). The optimal cut-off value, which maximizes the sensitivity and specificity, of CFF-A10 for predicting low fibrinogen levels below 150 mg/dL, was 8.4 mm, with a sensitivity of 80.7% and specificity of 67.9%; that of CFF-MA was 9.2 mm, with a sensitivity of 76.3% and specificity of 69.8%. Despite sufficient blood fibrinogen levels, patients with low CFF-A10 levels experienced more postoperative bleeding. CFF-A10 predicted fibrinogen loss faster and with the same accuracy as CFF-MA did. Low CFF-A10 levels, despite sufficient fibrinogen levels, may be associated with increased blood loss following CPB.


CFF-A10; CFF-MA; Fibrinogen; Hemostasis; Thromboelastometory

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Minako Furuta,Hisakatsu Ito,Shota Sakai,Daisuke Hibi,Mitsuaki Yamazaki. Evaluation of fibrinogen function by CFF-A10 in cardiac surgery. Signa Vitae. 2023. 19(6);52-59.


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