Coagulation activation in sickle cell trait: an exploratory study
Publication
, Journal Article
Amin, C; Adam, S; Mooberry, MJ; Kutlar, A; Kutlar, F; Esserman, D; Brittain, JE; Ataga, KI; Chang, J; Wolberg, AS; Key, NS
Published in: British Journal of Haematology
Recent epidemiologic data suggest that sickle cell trait (Hb;) is a risk factor for venous thromboembolism. We conducted an exploratory study of healthy subjects with 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 individuals were compared to 22 African‐American controls with a normal haemoglobin profile (Hb;) and 17 patients with sickle cell disease (Hb;). Plasma thrombin‐antithrombin complexes and D‐dimer levels were elevated in relative to patients ( = 0·0385 and = 0·017, respectively), and as expected, were much higher in ( < 0·0001 for both). Thrombin generation in platelet poor plasma was indistinguishable between and subjects, whereas a paradoxical decrease in endogenous thrombin potential was observed in (≤ 0·0001). Whole blood tissue factor was elevated in compared to ( = 0·005), but did not differ between and . Plasma microparticle tissue factor activity was non‐significantly elevated in ( = 0·051), but was clearly elevated in patients ( = 0·004) when compared to controls. Further studies in larger cohorts of subjects with sickle cell trait are needed to confirm the results of this preliminary investigation.
