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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 FVIII:C across conditions (mean ± SEM). ∗: different from baseline at P = .005. ∧: different from baseline at P = .02.
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fig2: Differences in FVIII:C across conditions (mean ± SEM). ∗: different from baseline at P = .005. ∧: different from baseline at P = .02.

Mentions: Repeated measures ANOVA indicated a nonsignificant time-by-plasma manipulation interaction, F(6, 234) = 2.13, ε = .488, P = .10, a nonsignificant main effect for plasma manipulation, F(1.9, 114.2) = 0.71, P = .49, and a significant main effect for time, F(1.6,114.2) = 4.06, P = .03. As shown in Figure 2, uncorrected FVIII:C significantly increased from baseline to stress (P = .005) and remained significantly elevated at recovery (P = .02), but plasma manipulation did not affect FVIII:C. Repeated measures ANOVA indicated no significant main effect for FVIII:C AUC, F(3, 117) = .933, ε = .632, P = .394. No significant differences emerged between uncorrected AUC (M = 275.83 ± 545.41), AUC corrected with plasma (M = 262.38 ± 477.35), AUC corrected with saline (M = 223.5 ± 494.28), or AUC corrected arithmetically (M = 224.48 ± 541.18).


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

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

Differences in FVIII:C across conditions (mean ± SEM). ∗: different from baseline at P = .005. ∧: different from baseline at P = .02.
© Copyright Policy
Related In: Results  -  Collection

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

fig2: Differences in FVIII:C across conditions (mean ± SEM). ∗: different from baseline at P = .005. ∧: different from baseline at P = .02.
Mentions: Repeated measures ANOVA indicated a nonsignificant time-by-plasma manipulation interaction, F(6, 234) = 2.13, ε = .488, P = .10, a nonsignificant main effect for plasma manipulation, F(1.9, 114.2) = 0.71, P = .49, and a significant main effect for time, F(1.6,114.2) = 4.06, P = .03. As shown in Figure 2, uncorrected FVIII:C significantly increased from baseline to stress (P = .005) and remained significantly elevated at recovery (P = .02), but plasma manipulation did not affect FVIII:C. Repeated measures ANOVA indicated no significant main effect for FVIII:C AUC, F(3, 117) = .933, ε = .632, P = .394. No significant differences emerged between uncorrected AUC (M = 275.83 ± 545.41), AUC corrected with plasma (M = 262.38 ± 477.35), AUC corrected with saline (M = 223.5 ± 494.28), or AUC corrected arithmetically (M = 224.48 ± 541.18).

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