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Comparison of stress-hemoconcentration correction techniques for stress-induced coagulation.

Austin AW, Patterson SM - Biomed Res Int (2013)

Bottom Line: For FVII:C, uncorrected AUC was significantly greater than AUC corrected arithmetically.For fibrinogen, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically.For D-dimer, uncorrected AUC was significantly greater than AUC corrected arithmetically.

View Article: PubMed Central - PubMed

Affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Office J-3145, 5400 Boulevard Gouin Ouest, Montreal, Quebec, Canada H4J 1C5 ; Department of Exercise Science, Concordia University, Montreal, Quebec, Canada H4B 1R6 ; Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada H4J 1C5.

ABSTRACT
When examining stress effects on coagulation, arithmetic correction is typically used to adjust for concomitant hemoconcentration but may be inappropriate for coagulation activity assays. We examined a new physiologically relevant method of correcting for stress-hemoconcentration. Blood was drawn from healthy men (N = 40) during baseline, mental stress, and recovery, and factor VII activity (FVII:C), factor VIII activity (FVIII:C), activated partial thromboplastin time (APTT), prothrombin time (PT%), fibrinogen, D-dimer, and plasma volume were determined. Three hemoconcentration correction techniques were assessed: arithmetic correction and two reconstitution techniques using baseline plasma or physiological saline. Area-under-the-curve (AUC) was computed for each technique. For FVII:C, uncorrected AUC was significantly greater than AUC corrected arithmetically. For PT%, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically. For APTT, uncorrected AUC was significantly less than AUC corrected with saline and greater than AUC corrected arithmetically. For fibrinogen, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically. For D-dimer, uncorrected AUC was significantly greater than AUC corrected arithmetically. No differences in AUC were observed for FVIII:C. Saline reconstitution seems most appropriate when adjusting for hemoconcentration effects on clotting time and activity. Stress-hemoconcentration accounted for the majority of coagulation changes.

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Differences in FVII:C across conditions (mean ± SEM). ∗: different from baseline at P < .02. ∧: different from uncorrected at P < .001.
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fig1: Differences in FVII:C across conditions (mean ± SEM). ∗: different from baseline at P < .02. ∧: different from uncorrected at P < .001.

Mentions: Due to an insufficient amount of plasma, FVII:C was not assessed during stress for one participant, leaving 39 participants for this analysis. Repeated measures ANOVA indicated a significant time-by-plasma manipulation interaction, F(6, 228) = 7.2, ε = .564, P < .001. The nature of this interaction is shown in Figure 1. Repeated measures ANOVA indicated a significant main effect for FVII:C AUC, F(3, 144) = 5.08, ε = .807, P = .005. Uncorrected AUC (M = 21.03 ± 206.65) was significantly greater than AUC corrected arithmetically (M = −31.70 ± 225.74, P = .001) but not significantly different from AUC corrected with plasma (M = 32.43 ± 227.08, P = .467) or AUC corrected with saline (M = −6.38 ± 239.25, P = .165). AUC corrected with plasma was significantly greater than AUC corrected with saline (P = .005) and AUC corrected arithmetically (P = .004). AUC corrected with saline was not significantly different from AUC corrected arithmetically (P = .249). Estimated effect sizes for comparisons between levels of hemostasis parameters after each plasma manipulation during stress and recovery to levels at baseline and to each other are presented in Table 2, and estimated effect sizes for AUC comparisons are presented in Table 3.


Comparison of stress-hemoconcentration correction techniques for stress-induced coagulation.

Austin AW, Patterson SM - Biomed Res Int (2013)

Differences in FVII:C across conditions (mean ± SEM). ∗: different from baseline at P < .02. ∧: different from uncorrected at P < .001.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814105&req=5

fig1: Differences in FVII:C across conditions (mean ± SEM). ∗: different from baseline at P < .02. ∧: different from uncorrected at P < .001.
Mentions: Due to an insufficient amount of plasma, FVII:C was not assessed during stress for one participant, leaving 39 participants for this analysis. Repeated measures ANOVA indicated a significant time-by-plasma manipulation interaction, F(6, 228) = 7.2, ε = .564, P < .001. The nature of this interaction is shown in Figure 1. Repeated measures ANOVA indicated a significant main effect for FVII:C AUC, F(3, 144) = 5.08, ε = .807, P = .005. Uncorrected AUC (M = 21.03 ± 206.65) was significantly greater than AUC corrected arithmetically (M = −31.70 ± 225.74, P = .001) but not significantly different from AUC corrected with plasma (M = 32.43 ± 227.08, P = .467) or AUC corrected with saline (M = −6.38 ± 239.25, P = .165). AUC corrected with plasma was significantly greater than AUC corrected with saline (P = .005) and AUC corrected arithmetically (P = .004). AUC corrected with saline was not significantly different from AUC corrected arithmetically (P = .249). Estimated effect sizes for comparisons between levels of hemostasis parameters after each plasma manipulation during stress and recovery to levels at baseline and to each other are presented in Table 2, and estimated effect sizes for AUC comparisons are presented in Table 3.

Bottom Line: For FVII:C, uncorrected AUC was significantly greater than AUC corrected arithmetically.For fibrinogen, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically.For D-dimer, uncorrected AUC was significantly greater than AUC corrected arithmetically.

View Article: PubMed Central - PubMed

Affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal, Office J-3145, 5400 Boulevard Gouin Ouest, Montreal, Quebec, Canada H4J 1C5 ; Department of Exercise Science, Concordia University, Montreal, Quebec, Canada H4B 1R6 ; Research Centre, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada H4J 1C5.

ABSTRACT
When examining stress effects on coagulation, arithmetic correction is typically used to adjust for concomitant hemoconcentration but may be inappropriate for coagulation activity assays. We examined a new physiologically relevant method of correcting for stress-hemoconcentration. Blood was drawn from healthy men (N = 40) during baseline, mental stress, and recovery, and factor VII activity (FVII:C), factor VIII activity (FVIII:C), activated partial thromboplastin time (APTT), prothrombin time (PT%), fibrinogen, D-dimer, and plasma volume were determined. Three hemoconcentration correction techniques were assessed: arithmetic correction and two reconstitution techniques using baseline plasma or physiological saline. Area-under-the-curve (AUC) was computed for each technique. For FVII:C, uncorrected AUC was significantly greater than AUC corrected arithmetically. For PT%, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically. For APTT, uncorrected AUC was significantly less than AUC corrected with saline and greater than AUC corrected arithmetically. For fibrinogen, uncorrected AUC was significantly greater than AUC corrected with saline or arithmetically. For D-dimer, uncorrected AUC was significantly greater than AUC corrected arithmetically. No differences in AUC were observed for FVIII:C. Saline reconstitution seems most appropriate when adjusting for hemoconcentration effects on clotting time and activity. Stress-hemoconcentration accounted for the majority of coagulation changes.

Show MeSH
Related in: MedlinePlus