A Longitudinal Analysis of Thrombin-Antithrombin Complex in Adult Sickle Cell Anemia during Vaso-occlusive Crisis and Steady State

Abstract: BACKGROUND: Hypercoagulability has been thought to be of great significant in the pathophysiology of sickle cell disease. This study was carried out to compare the plasma levels of Thrombin-antithrombin complex (TAT) in adult HbSS in steady state and vaso-occlusive crisis and HbA subjects with a view to exploring the role of TAT in vaso-occlusive crisis. METHODS: This was a hospital based longitudinal cohort study conducted during April to June 2022 among 31 HbSS consecutively recruited during painful crises and followed up into their steady states and 30 HbA participants. Sociodemographic data were collected. Full blood count and retic count, prothrombin time, activated partial thromboplastin time and TAT were determined. Data were analyzed using SPSS (IBM, Chicago) version 23. Continuous data were presented as Mean (SD) and comparison between the HbSS groups was by paired T-Test and HbA control by Student T-Test. Level of significance was set at p<0.05. RESULTS: The age range was 17-54 years and 22-54years for HbSS and HbA controls respectively. There was a significant difference in the mean plasma level of TAT in HbSS in crisis (compared with steady state (6.9±4.6ng/ml vs 3.3±2.3ng/ml, p<0.001) HbSS in steady state compared with and HbA control (3.3±2.3ng/ml vs 0.8±0.6 ng/ml, p<0.01). Plasma TAT was positively correlated with irreversible sickle erythrocytes (r=0.4, p<0.05) indicating a positive association between vaso-occlusion and TAT. CONCLUSION: This study suggests heightened hypercoagulable state in adult HbSS in vaso-occlusive crisis compared with steady state and therefore elevated TAT may be indication for the use of anticoagulant in vaso-occlusive crisis.