Original Article                                                                                                                                                                                                                                                                                                                                               OPEN ACCESS

 

Whole blood viscosity assessment issues II: prevalence in endothelial dysfunction and hypercoagulation

Ezekiel Uba Nwose

Western Pathology Cluster – NSW HealthSouth West Pathology Service, 590 Smollett Street Albury, NSW 2640, Australia.

  

Citation: Nwose EU. Whole blood viscosity assessment issues II: prevalence in endothelial dysfunction and hypercoagulation. North Am J Med Sci 2010; 2: 252-257.    

Doi: 10.4297/najms.2010.2252

Availability: www.najms.org

ISSN: 1947 – 2714

Abstract

Background: Virchow’s triad in cardiovascular disease comprises blood viscosity, plasma D-dimer and homocysteine as indices of three associated but separate vascular phenomena. Aims: This work investigates prevalence of hyperviscosity in hyperhomocysteinaemia and positive D-dimer; and differences or similarities in stasis status among sub-populations of hyperhomocysteinaemia vs. normohomocysteinaemia and negative vs. positive D-dimer. Patients and Methods: 10-years de-identified archived clinical pathology data for the period of January 1999 to December 2008 were audited. All cases tested for D-dimer (n=6845) and homocysteine (n=1665), which were concomitantly tested for haematocrit and total proteins, were extracted. Results: The results show a very low prevalence of hyperviscosity associated with a positive D-dimer sub-population (1.48%), which is not statistically different in comparison with the negative D-dimer sub-population. The prevalence of hyperviscosity associated with hyperhomocysteinaemia (5.04%) was statistically significantly higher in comparison to the normohomocysteinaemia sub-population (p = 0.05). The prevalence of low viscosity is significantly higher in the positive D-dimer sub-population relative to the negative D-dimer sub-population (p < 0.00001), but not different between hyperhomocysteinaemia vs. normohomocysteinaemia. Normoviscosity is statistically significantly commoner in normoviscosity relative to hyper-homocysteinaemia as well as in negative compared with positive D-dimer (p < 0.00001). Conclusion: The findings reported here suggest putting into perspective the specificity of whole blood viscosity relative to stasis, not necessarily sensitivity to disease conditions where it is implicated.

Keywords: Cardiovascular complications, clinical laboratory evaluation, D-dimer, homocysteine, stasis, Virchow’s triad, whole blood viscosity. 

Correspondence to: Western Pathology Cluster – NSW Health, South West Pathology Service; 590 Smollett Street Albury, NSW 2640, Australia. Tel: +612 60561651, Email: ezekiel.nwose@gsahs.health.nsw.gov.au