Relationship between assays of inflammation and coagulation: a novel interpretation of the canine activated clotting time.
The processes of inflammation and coagulation are known to be interconnected through several mechanisms; however, the influence of inflammation on the interpretation of coagulation assays remains unknown. Blood was collected from 87 dogs admitted to a tertiary referral intensive care unit (ICU) and 15 control dogs. The association between 2 markers of inflammation [mature neutrophil count and C-reactive protein (CRP)] and 5 coagulation parameters [activated clotting time (ACT), prothrombin time (PT), activated partial thromboplastin time (aPTT), antithrombin (AT), and platelet count (plt)] were evaluated through correlation analysis. The study population was then divided into 4 groups based on severity of ACT prolongation with comparisons to all other variables assessed through an analysis of variance (ANOVA) test. A strong correlation for a biological system was demonstrated between ACT and CRP (r = 0.66; P < 0.0001). Statistically significant results were also found between aPTT and AT with the markers of inflammation, but the correlations were weaker. Within ACT groups of increasing severity, higher CRP concentrations (P < 0.0001) and lower AT activities (P < 0.0001) were identified. This study provides evidence for an association between assays of inflammation and coagulation and suggests that modification of our traditional interpretations of coagulation assays may be required. As a point-of-care test, ACT is a simple and inexpensive tool that can be used to assess an underlying inflammatory or hemostatic process.
Canada West Veterinary Specialists and Critical Care Hospital, Vancouver, British Columbia V5M 4Y3, Canada. tcheng@uoguelph.ca
Teresa
T
Cheng
Karol A
KA
Mathews
Anthony C G
AC
Abrams-Ogg
R Darren
RD
Wood
D000818:Animals; D001772:Blood Cell Count / Q000662:veterinary; D001777:Blood Coagulation / Q000276:immunology*; D002097:C-Reactive Protein / Q000378:metabolism; D004283:Dog Diseases / Q000097:blood* / Q000175:diagnosis / Q000276:immunology*; D004285:Dogs; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000662:veterinary*; D010314:Partial Thromboplastin Time / Q000662:veterinary; D010976:Platelet Count / Q000662:veterinary; D011446:Prospective Studies; D011517:Prothrombin Time / Q000662:veterinary; D012016:Reference Values; D018709:Statistics, Nonparametric; D014914:Whole Blood Coagulation Time / Q000662:veterinary
D002097:C-Reactive Protein