Comparison of stress-hemoconcentration correction techniques for stress-induced coagulation.
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.
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.
Anthony W
AW
Austin
Stephen M
SM
Patterson
D000328:Adult; D001777:Blood Coagulation; D005167:Factor VII / Q000378:metabolism; D005169:Factor VIII / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D008297:Male; D010953:Plasma Volume; D011516:Prothrombin / Q000378:metabolism; D013315:Stress, Psychological / Q000097:blood* / Q000150:complications / Q000473:pathology; D013925:Thromboplastin / Q000378:metabolism
D005167:Factor VII; D011516:Prothrombin; D005169:Factor VIII; D005340:Fibrinogen; D013925:Thromboplastin