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Semin Thromb Hemost
DOI: 10.1055/a-2570-4455
Original Article

Impact of Hematocrit on Coagulation Measured by Rotational Thromboelastometry in Healthy Subjects and Patients with Polycythemia

Marie Martin
1   Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell » Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
2   Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
,
Elie Nader   *
1   Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell » Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
2   Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
,
Hamdi Rezigue   *
3   Service d'hématologie-hémostase, Hospices civils de Lyon, Bron, France
4   EA 4609-Hémostase et Cancer, SFR Lyon Est, Université Claude Bernard Lyon I, Lyon, France
,
Yesim Dargaud
3   Service d'hématologie-hémostase, Hospices civils de Lyon, Bron, France
4   EA 4609-Hémostase et Cancer, SFR Lyon Est, Université Claude Bernard Lyon I, Lyon, France
,
Céline Renoux
1   Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell » Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
2   Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
5   Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
,
Philippe Joly
1   Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell » Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
2   Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
5   Laboratoire de Biochimie et de Biologie Moléculaire, UF de Biochimie des Pathologies Erythrocytaires, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
,
Mael Heiblig
6   Service d'hématologie Lyon Sud, Hospices Civils de Lyon, Lyon, France
,
Christophe Nougier   *
3   Service d'hématologie-hémostase, Hospices civils de Lyon, Bron, France
4   EA 4609-Hémostase et Cancer, SFR Lyon Est, Université Claude Bernard Lyon I, Lyon, France
,
Philippe Connes   *
1   Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM) EA7424, Team « Vascular Biology and Red Blood Cell » Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
2   Laboratoire d'Excellence du Globule Rouge (Labex GR-Ex), PRES Sorbonne, Paris, France
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Abstract

Thrombotic and cardiovascular events are among the leading causes of death for patients with polycythemia, more specifically for those with primary origin. It has been suggested that the high hematocrit (Hct) would favor hypercoagulability. However, the impact of Hct on coagulation in patients with polycythemia has not been investigated so far. The aim of our study was to compare the coagulation profiles of healthy subjects and patients with polycythemia and to evaluate the in vitro impact of Hct on coagulation. Blood from healthy individuals (n = 100 for blood viscosity; n = 19 for coagulation) and patients with primary/secondary polycythemia (n = 29 for blood viscosity; n = 20 for coagulation) was used to perform measurements at native Hct. The impact of Hct modulation (20% vs. 50%) on coagulation was tested in vitro in 9 healthy subjects and 19 patients with polycythemia. Blood viscosity was measured by viscosimetry and coagulation and fibrinolysis by rotational thromboelastometry. In patients with polycythemia, Hct, and blood viscosity were higher, clotting time was prolonged and clot lysis was faster compared to healthy individuals. Our in vitro results showed that the clotting time was faster and the clot firmness higher at 20% versus 50% Hct for both populations, without any difference between the two populations at a given Hct. Our findings suggest that the interpretation of thromboelastometry results should be approached with caution in patients with high Hct. The in vivo hypercoagulable state of patients with polycythemia is probably the consequence of changes in hemodynamic conditions attributed to blood hyper-viscosity, that may promote venous stasis and platelet margination.

Keywords

hematocrit - thromboelastometry - polycythemia - clot

* These authors contributed equally to this article.


Supplementary Material



Publication History

Received: 06 December 2024

Accepted: 31 March 2025

Accepted Manuscript online:
01 April 2025

Article published online:
25 April 2025

© 2025. Thieme. All rights reserved.

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