Coagulation activation in sickle cell trait: an exploratory study |
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| Authors: | Chirag Amin Soheir Adam Micah J. Mooberry Abdullah Kutlar Ferdane Kutlar Denise Esserman Julia E. Brittain Kenneth I. Ataga Jen‐Yea Chang Alisa S. Wolberg Nigel S. Key |
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| Affiliation: | 1. Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA;2. Department of Medicine, Georgia Regents University, Augusta, GA, USA;3. Department of Biostatistics, School of Public Health, Yale University, New Haven, CT, USA;4. Department of Cell Biology and Anatomy, Georgia Regents University, Augusta, GA, USA;5. Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA |
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| Abstract: | Recent epidemiologic data suggest that sickle cell trait (HbAS; AS) is a risk factor for venous thromboembolism. We conducted an exploratory study of healthy subjects with AS under baseline conditions to determine whether a chronic basal hyperactivation of coagulation exists, and if so, what mechanism(s) contribute to this state. Eighteen healthy AS individuals were compared to 22 African‐American controls with a normal haemoglobin profile (HbAA; AA) and 17 patients with sickle cell disease (HbSS; SS). Plasma thrombin‐antithrombin complexes and D‐dimer levels were elevated in AS relative to AA patients (P = 0·0385 and P = 0·017, respectively), and as expected, were much higher in SSversusAA (P < 0·0001 for both). Thrombin generation in platelet poor plasma was indistinguishable between AA and AS subjects, whereas a paradoxical decrease in endogenous thrombin potential was observed in SS (P ≤ 0·0001). Whole blood tissue factor was elevated in SS compared to AA (P = 0·005), but did not differ between AA and AS. Plasma microparticle tissue factor activity was non‐significantly elevated in AS (P = 0·051), but was clearly elevated in SS patients (P = 0·004) when compared to AA controls. Further studies in larger cohorts of subjects with sickle cell trait are needed to confirm the results of this preliminary investigation. |
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| Keywords: | sickle venous thrombosis tissue factor coagulation thrombin |
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