Influence of Gender and Subjects’ Condition on Haemostatic Parameters in Sickle Cell Anaemia and Control Subjects

Aim: The aim of this study was to assess the influence of gender and subjects’ condition on haemostatic parameters in sickle cell anaemia and control subjects.

Study Design: This study is a cross-sectional observational study.

Place and Duration of Study: University of Port Harcourt Teaching Hospital, Rivers State, and the Federal Medical Centre, Yenagoa, Bayelsa State, between the months of February and August, 2020.

Methodology: A total of four hundred and fifty (450) subjects with age range of 1-50 years were randomly selected. Out of the four hundred and fifty (450) subjects, 269 (59.78%) were males and 181 (40.22%) were females. The subjects were further grouped into three based on the subjects’ condition, which include steady state (n=150), vaso-occlusive crisis (n=150); and the control (n=150). There were 200 registered patients (adults and children alike) at the sickle cell clinics of the University of Port Harcourt Teaching Hospital, and the Federal Medical Centre, Yenagoa, with an average of 4 new patients per month. The sample size was obtained using a prevalence of sickle cell anaemia of 2% and was calculated using Cochrane formula. Five milliliters (5ml) of venous blood sample was withdrawn. The haemostatic parameters (vWF, FVIII, D-dimer, L-arginine, fibrinogen, ADAMTS13) were assayed quantitatively with Bioassay Technozym kit using Microplate Reader (Labtech microplate auto ELISA plate reader, an IS0 13485:2003 CE and WHO compliance Co., Ltd. Shanghai International Holding Corp. GmbH; Europe) calibrated to a wavelength of 450 nm with strict adherence to the manufacturer's instructions, while PT and APTT were analyzed with Fortress reagent and Uniscope SM801A Laboratory using water bath. Data management and statistical analyses were conducted using Statistical Analyses System SAS 9.4 (SAS Institute, Cary, North Carolina, USA) and p values <0.05 were considered statistically significant.

Results: The results showed that There was significant variability in the haemostatic parameters by subjects’ condition. The comparison of HbF and haemostatic parameters showed significant (p<0.05) increase and decrease in VOC and steady state respectively compared with the control group. Subject condition as an independent factor predicts significantly high 72.91% and 86.00% for ADAMTS13 and for vWF activations respectively compared to other factors.

Conclusion: Subjects with SCA, particularly during VOC, undergo significant haematologic alterations that increase their risk of developing coagulation activation-related complications. Thus, though selected markers of coagulation were significantly different between the subject conditions, they were often significantly higher in the SCA.