Effect of Anticoagulant Therapy on Platelet Function Parameters in Blood Transfusion Recipients at the University of Uyo Teaching Hospital, Nigeria

Abstract

Background: Anticoagulant therapy is widely used for the prevention and management of thromboembolic disorders, but its effects on platelet-related and coagulation parameters require appropriate laboratory monitoring to support safe and effective treatment. Aim: This study assessed selected platelet function-related, haematological and coagulation parameters among patients receiving anticoagulant therapy at the University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria. Methods: A cross-sectional comparative study was conducted among 92 participants, comprising 46 patients receiving anticoagulant therapy and 46 apparently healthy controls. Seven millilitres (7.0 mL) of venous blood were collected from each participant for full blood count estimation using the Sicuro HEMIA 5D automated haematology analyser and coagulation profile analysis. Reagents from Agappe Diagnostics Ltd. were used for the determination of Prothrombin Time (PT), Activated Partial Thromboplastin Time (aPTT) and fibrinogen concentration in samples using a manual clot-based method. The INR was calculated from PT values using the International Sensitivity Index (ISI), fibrinogen concentration was measured using the Clauss clotting method, while D-dimer concentration was measured using a fluorescence immunoassay (FIA) method with reagents from Boditech Med/iChroma Ltd. Statistical analysis was performed using IBM SPSS Statistics Version 32.0.0. Continuous variables were presented as means ± standard deviations and medians, where appropriate. Between-group comparisons were performed using Welch's independent-samples t-test (two-sided, α=0.05). Pearson correlation was used to assess associations of laboratory parameters with age and duration of anticoagulant therapy within the anticoagulant group. Sex-stratified comparisons used Welch's t-test. Results: The platelet count in the anticoagulant group, 220.26 ± 58.81x 109/L was significantly lower than the platelet count in controls of 255.54 ± 104.55 x 109/L (t=1.994; p=0.004). A similar pattern was observed for plateletcrit and PDW. MPV did not differ significantly between groups. On the other hand, the anticoagulant group demonstrated significantly prolonged PT (19.87 ± 4.63s vs 12.47 ± 0.61s respectively), aPTT (36.48 ± 5.12s vs 30.56 ± 2.77s respectively), and a higher INR (1.72 ± 0.57) compared with controls (1.07 ± 0.10) (p < 0.0001). D-dimer was significantly higher among participants receiving anticoagulants (430.43 ± 94.52 ng/mL vs 257.61 ± 72.55 ng/mL) (p < 0.0001). Fibrinogen concentrations did not differ significantly between groups. Significant differences were also observed in MCV, MCH, neutrophil, lymphocyte and basophil percentages. The duration of anticoagulant therapy showed significant associations with WBC, RBC, haemoglobin and haematocrit. Conclusion: These findings demonstrate that patients receiving anticoagulant therapy had significant alterations in haematological and coagulation parameters compared with controls, highlighting the importance of comprehensive laboratory monitoring to assess haemostatic status during anticoagulant therapy.