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To screen for APC-R associated with venous thromboembolic disorders.

Antinuclear antibodies are associated with rheumatic diseases including Systemic Lupus Erythematous (SLE), mixed connective tissue disease, Sjogren's syndrome, scleroderma, polymyositis, CREST syndrome, and neurologic SLE. 

Reflex Information: If ANA Screen, IFA is positive, then ANA Titer and Pattern will be performed at an additional charge.



Apolipoprotein A1 (APO A1) has been reported to be a better predictor than HDL cholesterol and triglycerides for Coronary Artery Disease (CAD). Low levels of APO A1 in serum are associated with increased risk of CAD. The measurement of APO A1 may be of value in identifying patients with atherosclerosis. Apolipoprotein B (APO B) has been reported to be a more powerful indicator of CAD than total cholesterol or LDL cholesterol in angiographic CAD and in survivors of myocardial infarction. In some patients with CAD, APO B is elevated even in the presence of normal LDL cholesterol.

BNP is increased in congestive heart failure, left ventricular hypertrophy, acute myocardial infarction, coronary angioplasty, and hypertension. Elevations are also observed in pulmonary hypertension (indicating right ventricular dysfunction), acute lung injury, hypervolemic states, chronic renal failure and cirrhosis. Decreasing levels indicate therapeutic response to anti-hypertensive therapy.

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To screen for and monitor kidney dysfunction in those with known or suspected kidney disease. Cystatin C is a relatively small protein that is produced throughout the body by all cells that contain a nucleus and is found in a variety of body fluids, including the blood. It is produced, filtered from the blood by the kidneys, and broken down at a constant rate. This test measures the amount of cystatin C in blood to help evaluate kidney function.Cystatin C is filtered out of the blood by the glomeruli, clusters of tiny blood vessels in the kidneys that allow water, dissolved substances, and wastes to pass through their walls while retaining blood cells and larger proteins. What passes through the walls of the glomeruli forms a filtrate fluid. From this fluid, the kidneys reabsorb cystatin C, glucose, and other substances. The remaining fluid and wastes are carried to the bladder and excreted as urine. The reabsorbed cystatin C is then broken down and is not returned to the blood.


Factor V (Leiden) Mutation is a point mutation that causes resistance of Factor V protein degradation by activated protein C (APC). This mutation is associated with increased risk of venous thrombosis.

Description: A Fibrinogen Activity Clauss test is a blood test that measures the amount of active Fibrinogen in your blood to evaluate your blood’s ability to form clots.

Also Known As: Fibrinogen Activity Test, Factor 1 Assay Test, Cardiac Fibrinogen Test, Fibrinogen Test, Clotting factors Test

Collection Method: Blood Draw

Specimen Type: Whole Blood

Test Preparation: No preparation required

When is this test ordered?

A fibrinogen activity test may be ordered by a doctor if someone:

  • Has any unexplained or prolonged bleeding
  • Has thrombosis
  • Has a PT and PTT test result that is abnormal
  • Has DIC or abnormal fibrinolysis symptoms or is being treated for it.
  • Has or may have inherited coagulation factor deficiency or dysfunction
  • Has a bleeding issue, and their health care provider wishes to assess and monitor their clotting capacity

When someone obtains a low result on a fibrinogen activity test, a fibrinogen antigen test may be used to establish whether the low result is due to insufficient or malfunctioning fibrinogen.

Coronary heart disease, myocardial infarction, and peripheral artery disease have all been linked to high fibrinogen levels. When a health practitioner wants to assess an individual's risk of developing cardiovascular disease, fibrinogen activity testing may be used in conjunction with other tests.

What is being tested?

Fibrinogen is a protein that is a coagulation factor in the production of blood clots. A fibrinogen activity test determines how well fibrinogen aids in the formation of a blood clot, whereas a fibrinogen antigen test determines the amount of fibrinogen in the blood.

Fibrinogen is produced in the liver, and is then delivered into the bloodstream along with many other coagulation factor proteins. Hemostasis stops bleeding at the site of injury when a blood vessel or body tissue is damaged. Platelets, small cell fragments, stick to and cluster at the site, triggering a coagulation cascade in which clotting components are activated one by one.

As the cascade develops, soluble fibrinogen turns into insoluble fibrin strands. At the wound site, a fibrin net is created by the crosslinking of these threads and stabilizes it. Together with the platelets, the fibrin net adheres to the area of injury and creates a solid blood clot. This barrier prevents more blood loss and is present while the injured area recovers.

There must be enough typically functioning platelets and coagulation factors for a stable clot to form. It can cause bleeding episodes and/or the creation of an inappropriate blood clot if there are defective factors or platelets, or if there are too few or too many of them. Hemostasis can be assessed using a variety of laboratory techniques, including fibrinogen assays.

Coagulation tests are now known to be based on what happens artificially in the test setting and so do not always reflect what happens in the body. The tests can, however, be used to assess individual components of the hemostasis system. The fibrinogen activity test measures the amount of soluble fibrinogen that is transformed into fibrin threads during the hemostatic process. The fibrinogen test bypasses the rest of the coagulation factors and concentrates on the function of fibrinogen after adding thrombin to the test sample.

A fibrinogen activity test determines how long it takes for a fibrin clot to form after a standard dose of thrombin is added to plasma. This test assesses the function of fibrinogen, specifically its capacity to convert into fibrin. The amount of active fibrinogen present directly correlates with the time it takes for a clot to develop. Prolonged clot formation periods can be caused by low levels of normal fibrinogen or by fibrinogen that is dysfunctional.

Acute phase reactants are a group of blood components that include fibrinogen. When conditions cause acute tissue inflammation or injury, blood levels of fibrinogen and other acute phase reactants rise dramatically. These acute phase reactants, including fibrinogen, can be tested to see how much inflammation is present in the body.

Related Laboratory Tests and Panels:

  • PT and INR
  • PTT
  • D-Dimer
  • Coagulation Factors
  • Thrombin Time
  • Hs-CRP
  • Complete Blood Count CBC

Related Conditions:

  • Excessive Clotting Disorders
  • Bleeding Disorders
  • Liver Disease
  • Cardiovascular Disease
  • DIC

Commonly Asked Questions:

How is this type of test used by my health care provider?

This test is designed to assess fibrinogen, a protein that is required for the production of blood clots. When an injury happens and bleeding occurs, the body goes through a sequence of actions to build a blood clot. One of the final phases is converting soluble fibrinogen into insoluble fibrin threads that crosslink to form a net that stabilizes and binds to the injured site until it heals.

A fibrinogen activity test assesses fibrinogen's function and capacity to convert to fibrin. It's utilized to:

  • It's utilized to:
  • As follow-up testing to an abnormal bleeding disorder test result and/or an episode of prolonged or inexplicable bleeding
  • To help detect disseminated intravascular coagulation or aberrant fibrinolysis, testing such as Prothrombin, Partial Thromboplastin Times, Platelet Count, and D-dimer are often ordered.
  • Occasionally, to aid in the monitoring of the progress of a progressive disease over time, or, in rare cases, to aid in the monitoring of the treatment of an acquired ailment.

Other cardiac risk markers, such as C-reactive protein, are sometimes used to assist in evaluating a person's overall risk of developing cardiovascular disease. However, because there are no direct treatments for increased levels, this application of the test has not achieved general adoption. Many health professionals, on the other hand, believe that measuring fibrinogen activity provides them with extra information that may drive them to be more aggressive in addressing those risk factors that they can control.

What do my fibrinogen activity test results mean?

The concentration of protein in the blood is reported as the result of a fibrinogen test. 

The presence of normal fibrinogen activity usually indicates that the blood clotting ability is normal.

Reduced or malfunctioning fibrinogen may be the cause of significantly reduced fibrinogen activity. Reduced fibrinogen activity and antigen levels can make it more difficult for the body to produce a stable blood clot.

Reduced production owing to a hereditary illness such as afibrinogenemia or hypofibrinogenemia, or a condition such as malnutrition or liver disease, can cause chronically low levels.

Acutely low levels are frequently associated with fibrinogen consumption, such as in disseminated intravascular coagulation and irregular fibrinolysis, which happens when the body is overly active in removing blood clots. Reduced fibrinogen levels can also occur as a result of quick, large-volume blood transfusions or in malnourished patients.

A ratio of the antigen test and the activity test is sometimes used by a doctor. This is to differentiate dysfibrinogenemia from hypofibrinogenemia.

Fibrinogen is an acute phase reactant, which means that it can rapidly rise in amounts in any situation that causes inflammation or tissue injury. Elevated fibrinogen concentrations aren't specific, which means they don't inform the doctor what's causing the problem or where it's happening. These increases in fibrinogen are usually just transitory, returning to normal after the underlying problem is treated. Elevated levels can be seen in the following ways:

  • Infections that are severe
  • Cancer
  • Myocardial infarction, coronary artery disease
  • Stroke
  • Inflammatory conditions
  • Trauma
  • Smoking a cigarette
  • Pregnancy
  • Peripheral artery disease, a condition that affects the arteries
  • When fibrinogen levels are high, a person's risk of cardiovascular disease and producing a blood clot is raised

We advise having your results reviewed by a licensed medical physician for proper interpretation of your results.


Low levels of fibrinogen are associated with bleeding most commonly secondary to liver disease or Disseminated Intravascular Coagulation (DIC). Fibrinogen is an acute phase reactant and thus elevated levels may be associated with inflammation. Increased concentrations are also associated with increased risk of atherosclerosis.

Diabetic nephropathy is a complication of diabetes and is characterized by proteinuria. Before overt proteinuria develops, albumin excretion increases in those diabetic patients who are destined to develop diabetic nephropathy. There is a need to identify small, but abnormal, increases in the excretion of urinary albumin (in the range of 30-300 mg/day, ie, microalbuminuria). The National Kidney Foundation guidelines for the management of patients with diabetes and microalbuminuria recommend that all type 1 diabetic patients older than 12 years and all type 2 diabetic patients younger than 70 years have their urine tested for microalbuminuria yearly when they are under stable glucose control.

Patients with vascular diseases will generally have either a C-ANCA pattern or P-ANCA pattern, and give positive results in specific tests for PR-3 or MPO. Patients with bowel disease have been shown to have antibodies that give a P-ANCA or C-ANCA pattern. These antibodies, however, may not be directed toward MPO. Patients with drug induced lupus, etc., often present with a P-ANCA pattern that is associated with antibodies against MPO.

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Assessment of skeletal muscle breakdown (rhabdomyolysis).


Screening test for deficiencies of plasma coagulation factors other than Factors VII and XIII. The test is also used to monitor patients on heparin therapy.

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BNP is used to aid in the diagnosis of left ventricular dysfunction in heart failure. In contrast with BNP, a drug to treat left ventricular dysfunction does not interfere with the measurement of N-terminal pro-BNP.

Dietary supplements containing biotin may interfere in assays and may skew results to be either falsely high or falsely low. For patients receiving the recommended daily doses of biotin, draw samples at least 8 hours following the last biotin supplementation. For patients on mega-doses of biotin supplements, draw samples at least 72 hours following the last biotin supplementation.


Screening test for abnormalities of coagulation factors that are involved in the extrinsic pathway. Also used to monitor effects of Warfarin therapy and to study patients with hereditary and acquired clotting disorders.

Useful in differentiating inflammatory and neoplastic diseases and as an index of disease severity. CRP is also useful in monitoring inflammatory disease states.