The circadian rhythm of selected parameters of the hemostasis system in healthy people

Abstract

In this paper we tested a group of 66 healthy volunteers in terms of the influence of circadian rhythm on selected parameters of the coagulation system and fibrinolytic system. Blood was collected at 6-hour intervals, at 8 am, 2 pm, 8 pm and 2 am. Circadian variability was observed in the coagulation system parameters as well as in the fibrinolytic system. We observed increased platelet aggregation, APTT prolongation, along with increased levels of factors (fibrinogen, PAI-1) and PAP and TAT complexes that influence coagulation and fibrinolysis systems, in the blood samples collected in the morning (8 am). We also demonstrated a circadian rhythm in the number of circulating platelets (PLT), with a peak in the afternoon (2 pm) accompanied by increased concentrations of t-PA, D-dimers and PT prolongation. Based on the obtained results it was possible to conclude that circadian rhythm had an influence on the activation of coagulation processes in the morning, with a progressive activation of fibrinolysis up to the afternoon. Our results may be helpful in determining the transient risk of cardiovascular events, including myocardial infarction and ischemic stroke, and hence, can contribute to the effective prevention of such events. Such observations may also become a starting point of departure for further studies aimed at determining the circadian effect of secretion of parameters in the hemostasis system on the other systems and parameters in the human body.

Management of the thrombotic risk associated with COVID-19: guidance for the hemostasis laboratory

“…Interestingly, PAI-1 follows a circadian rhythm in humans, with a morning peak (around 8 AM) independent from the sleep pattern [ 75 , 76 ]. The time-interval between blood collection and analysis, the anticoagulant used in sample tubes and storage temperature are other variables that are known to have an impact on plasma PAI-1 measurement [ 77 – 79 ].…”

Chronobiological patterns of acute aortic dissection in central China

“…7 In addition, the balance between coagulation and fibrinolysis is also disturbed, resulting in hypercoagulability and hypofibrinolysis in the morning. 20 The surges in BP and BP reactivity, together with other changes in the cardiovascular system, would increase arterial shear force, triggering the onset of AAD in corresponding periods, especially in people with a genetic predisposition.…”

The Role of Clock Genes in Fibrinolysis Regulation: Circadian Disturbance and Its Effect on Fibrinolytic Activity

“…A clear circadian expression of prothrombotic factors such as von Willebrand factor has also been shown, displaying maximum expression during the activity phase in humans and rodents, while on the other hand demonstrating a clear regulation of fibrinogen expression through clock genes (Somanath et al, 2011). Also, parameters of the coagulation system, such as prothrombin time (PT) and activated partial thromboplastin time (APTT), displayed a circadian rhythm, with the shortest PT being recorded late at night and early in the morning (Budkowska et al, 2019). All the expression profiles of circadian hemostasis previously described favor a prothrombotic phenotype when the circadian function of the molecular clock is deregulated.…”

“…Thus far, we know that tPA and PAI-1 plasma levels oscillate robustly in circadian form in humans and rodents, decreasing and increasing, respectively, during the activity phase in both species, contributing to a state of hypofibrinolysis during this period (Angleton et al, 1989;Andreotti and Kluft, 1991;Ohkura et al, 2007;Scheer and Shea, 2014;Budkowska et al, 2019). This feature allows rodent models to be used for investigating the mechanisms that regulate fibrinolysis and its possible damage (see Figure 1).…”