Anticoagulant action of low, physiologic, and high albumin levels in whole blood

PLoS One. 2017 Aug 11;12(8):e0182997. doi: 10.1371/journal.pone.0182997. eCollection 2017.

Abstract

Albumin is the most abundant plasma protein. Critical illness is often associated with altered, predominately decreased, serum albumin levels. This hypoalbuminaemia is usually corrected by administration of exogenous albumin. This study aimed to track the concentration-dependent influence of albumin on blood coagulation in vitro. Whole blood (WB) samples from 25 volunteers were prepared to contain low (19.3 ± 7.7 g/L), physiological (45.2 ± 7.8 g/L), and high (67.5 ± 18.1 g/L) levels of albumin. Haemostatic profiling was performed using a platelet function analyzer (PFA) 200, impedance aggregometry, a Cone and Platelet analyzer (CPA), calibrated automated thrombogram, and thrombelastometry (TEM). Platelet aggregation-associated ATP release was assessed via HPLC analysis. In the low albumin group, when compared to the physiological albumin group, we found: i) shortened PFA 200-derived closure times indicating increased primary haemostasis; ii) increased impedance aggregometry-derived amplitudes, slopes, ATP release, as well as CPA-derived average size indicating improved platelet aggregation; iii) increased TEM-derived maximum clot firmness and alpha angles indicating enhanced clot formation. TEM measurements indicated impaired clot formation in the high albumin group compared with the physiological albumin group. Thus, albumin exerted significant anticoagulant action. Therefore, low albumin levels, often present in cancer or critically ill patients, might contribute to the frequently occurring venous thromboembolism.

MeSH terms

  • Adult
  • Anticoagulants / pharmacology*
  • Blood Coagulation / drug effects*
  • Blood Coagulation Tests
  • Blood Platelets / cytology
  • Blood Platelets / drug effects*
  • Blood Platelets / physiology
  • Cells, Cultured
  • Female
  • Humans
  • Male
  • Platelet Aggregation / drug effects*
  • Platelet Function Tests
  • Serum Albumin / pharmacology*

Substances

  • Anticoagulants
  • Serum Albumin

Grants and funding

This study was supported by a grant from the “Franz Lanyar-Stiftung” P#393 and by the “Österreichische Forschungsförderungsgesellschaft (FFG)” grant #857011 to GC. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.