Elevated D-dimer levels in African Americans with sickle cell trait

Microvascular and macrovascular thrombosis is thought to contribute significantly to the pathophysiology of complications in sickle cell disease (SCD). The mechanism of hypercoagulability in SCD is multifactorial, including activation of coagulation at the surface of sickled cells, endothelial dysfunction, and inflammation. D-dimer levels and other markers of coagulation activation are elevated in SCD and have been shown to correlate to stroke, retinopathy, and vaso-occlusive crises. Increased inflammatory and endothelial adhesion markers have also been observed in SCD, contributing to leukocyte and coagulation activation. Although recent evidence suggests that, similar to SCD, African Americans with sickle cell trait (SCT) are at increased risk of venous thromboembolism (VTE), and particularly pulmonary embolism, compared with noncarriers, only a few prior studies evaluating circulating coagulation and inflammatory markers have been performed in SCT. Using data from a large population-based cohort, the Jackson Heart Study (JHS), we investigated the association of SCT carrier status with available biomarkers in African Americans.