SYSTEMATIC REVIEW article
Front. Cardiovasc. Med.
Sec. Thrombosis and Haemostasis
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1671405
Treatment Effects of Fibrinogen Concentrates Versus Cryoprecipitate for Correcting Hypofibrinogenemia in Cardiac Surgery Patients: a Systematic Review and Meta-analysis
Provisionally accepted
Yue Chen1
Wenjie Yang2
Chongyang Zhao1Fujue Wang1Pengwei Ren1Xuemei Liu1
Tingyong Cao3
Ji Shuming1
Lei Chen1*
Deying Kang1*- 1West China Hospital of Sichuan University, Chengdu, China
- 2West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China
- 3Lanzhou University Second Hospital, Lanzhou, China
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Abstract Background Hypofibrinogenemia in cardiac surgery increases bleeding risk, but the efficacy and safety of fibrinogen concentrate versus cryoprecipitate remain unclear. This meta-analysis compares the patient-important outcomes associated with the use of fibrinogen concentrate versus cryoprecipitate for the management of acquired hypofibrinogenemia in cardiac surgery. Methods Medline, Embase, Cochrane Library, and Transfusion Evidence Library were searched from their inception until June 2024. Eligible studies included randomized clinical trials (RCTs). Effect estimates were synthesized using risk ratios (RR) and standardized mean differences (SMD), along with their corresponding 95% confidence intervals (CIs). Results We analyzed 4 RCTs (945 participants: 823 adults, 122 children) comparing fibrinogen concentrate with cryoprecipitate undergoing cardiac surgery. Meta-analysis showed no difference in mortality (RR=1.25, 95%CI:0.79-1.96; moderate GRADE), blood loss (SMD=-0.14, 95%CI:-0.46-0.18), transfusion rates (blood cells: RR=0.98, 0.77-1.26; platelets: RR=0.17, 0.02-1.40; fresh frozen plasma: RR=0.48, 0.16-1.45; cryoprecipitate: RR=1.02, 0.58-1.81), infections (RR=0.91, 0.64-1.28), volume overload (RR=1.95, 0.18-21.34), transfusion reactions (RR=0.98, 0.06-15.54), or postoperative thrombosis (RR=0.76, 0.47-1.22). No allergic reactions were reported. Subgroup analysis revealed substantial heterogeneity (I² = 0% to 98%) in most outcome measures between adults and children. Using the GRADE criteria, we
Keywords: Hypofibrinogenemia, cardiac surgery, Cardiopulmonary Bypass, Fibrinogen concentrates, Cryoprecipitate, Meta-analysis
Received: 25 Jul 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Chen, Yang, Zhao, Wang, Ren, Liu, Cao, Shuming, Chen and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lei Chen, leilei_25@126.com
Deying Kang, deyingkang@126.com
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