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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 APTT across conditions (mean ± SEM). ∗: different from baseline and arithmetic correction at P < .001 and saline reconstitution at P = .006. ∧: different from baseline and saline reconstitution at P < .04. +: different from baseline, uncorrected, plasma reconstitution, and saline reconstitution at P < .001.
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fig4: Differences in APTT across conditions (mean ± SEM). ∗: different from baseline and arithmetic correction at P < .001 and saline reconstitution at P = .006. ∧: different from baseline and saline reconstitution at P < .04. +: different from baseline, uncorrected, plasma reconstitution, and saline reconstitution at P < .001.

Mentions: Figure 4 details the repeated measures ANOVA for APTT, which indicated a significant time-by-plasma manipulation interaction, F(6, 234) = 15.27, ε = .636, P < .001. Friedman's test was significant for APTT AUC, X2(3) = 27.54, P < .001. Wilcoxon Signed-Rank tests suggest that uncorrected AUC (M = −15.21 ± 31.26) was significantly less than AUC corrected with saline (M = −6.31 ± 33.03, P < .001) and significantly greater than AUC corrected arithmetically (M = −26.67 ± 42.79, P = .001) but was not significantly different from AUC corrected with plasma (M = −13.48 ± 32.87, P = .35). AUC corrected with saline was significantly greater than AUC corrected arithmetically (P < .001) and significantly greater than AUC corrected with plasma (P = .005). AUC corrected with plasma was significantly greater than AUC corrected arithmetically (P = .004).


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

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

Differences in APTT across conditions (mean ± SEM). ∗: different from baseline and arithmetic correction at P < .001 and saline reconstitution at P = .006. ∧: different from baseline and saline reconstitution at P < .04. +: different from baseline, uncorrected, plasma reconstitution, and saline reconstitution at P < .001.
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Related In: Results  -  Collection

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

fig4: Differences in APTT across conditions (mean ± SEM). ∗: different from baseline and arithmetic correction at P < .001 and saline reconstitution at P = .006. ∧: different from baseline and saline reconstitution at P < .04. +: different from baseline, uncorrected, plasma reconstitution, and saline reconstitution at P < .001.
Mentions: Figure 4 details the repeated measures ANOVA for APTT, which indicated a significant time-by-plasma manipulation interaction, F(6, 234) = 15.27, ε = .636, P < .001. Friedman's test was significant for APTT AUC, X2(3) = 27.54, P < .001. Wilcoxon Signed-Rank tests suggest that uncorrected AUC (M = −15.21 ± 31.26) was significantly less than AUC corrected with saline (M = −6.31 ± 33.03, P < .001) and significantly greater than AUC corrected arithmetically (M = −26.67 ± 42.79, P = .001) but was not significantly different from AUC corrected with plasma (M = −13.48 ± 32.87, P = .35). AUC corrected with saline was significantly greater than AUC corrected arithmetically (P < .001) and significantly greater than AUC corrected with plasma (P = .005). AUC corrected with plasma was significantly greater than AUC corrected arithmetically (P = .004).

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