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Ding H, Chai R, Yin Y, Li W, Jiang S. Platelet-to-albumin ratio is an independent predictor for ventricular aneurysm formation in ST segment elevation myocardial infarction. Coron Artery Dis 2025; 36:117-125. [PMID: 39492711 PMCID: PMC11781557 DOI: 10.1097/mca.0000000000001445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Accepted: 10/13/2024] [Indexed: 11/05/2024]
Abstract
BACKGROUND Left ventricular aneurysm (LVA) is a common complication of acute myocardial infarction. We aimed to investigate the association of the platelet-to-albumin ratio (PAR) with LVA formation in patients with acute ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS A total of 767 consecutive patients with STEMI were prospectively enrolled. Logistic regression analysis and restricted cubic spline (RCS) were used to assess the association between PAR and LVA formation. The predictive ability of PAR and combined variable for LVA formation were assessed using receiver-operating characteristic (ROC) curve. RESULTS The prevalence of LVA was 14.1%. Univariable logistic regression analysis revealed that PAR was associated with the risk of LVA at both 1 month [odds ratio (OR) = 4.42, P < 0.001] and 6 months (OR = 4.35, P < 0.001) of follow-up. The predictive value of PAR remained significant even after multivariate logistic regression analysis at 1 month (OR = 3.42, P = 0.004) and 6 months (OR = 4.28, P < 0.001). RCS analysis revealed a nonlinear association between a higher PAR and an increased risk of LVA (nonlinear P < 0.05). In addition, the predictive abilities of PAR for LVA were 0.659. The combination of PAR, hemoglobin, left ventricular ejection fraction, and the use of angiotensin-converting enzym inhibitor/angiotensin receptor blocker significantly enhanced the ability to predict LVA formation (C statistic= 0.887). CONCLUSION A higher PAR was significantly associated with an increased risk of LVA formation in patients with acute STEMI who underwent primary PCI.
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Affiliation(s)
- Haifeng Ding
- Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Rui Chai
- Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Yin Yin
- Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Wenwen Li
- Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China
| | - Shijiu Jiang
- Division of Cardiology, The First Affiliated Hospital of Shihezi University, Shihezi, China
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Hosseini N, Soflaei SS, Salehi-Sangani P, Yaghooti-Khorasani M, Shahri B, Rezaeifard H, Esmaily H, Ferns GA, Moohebati M, Ghayour-Mobarhan M. Association of Premature Ventricular Contraction (PVC) with hematological parameters: a data mining approach. Sci Rep 2025; 15:2514. [PMID: 39833257 PMCID: PMC11756411 DOI: 10.1038/s41598-025-86557-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 01/13/2025] [Indexed: 01/22/2025] Open
Abstract
Premature ventricular contraction (PVC) is characterized by early repolarization of the myocardium originating from Purkinje fibers. PVC may occur in individuals who are otherwise healthy. However, it may be associated with some pathological conditions. In this research the association between hematological factors and PVC was studied. In this study, 9,035 participants were enrolled in the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. The association of hematological factors with PVC was evaluated using different machine learning (ML) algorithms, including logistic regression (LR), C5.0, and boosting decision tree (DT). The dataset was divided into training and test, and each model's performance was appraised on the test dataset. All data analyses used SPSS version 26 and SPSS Modeler 10. The results show that the Boosting DT was the most effective algorithm. Boosting DT had an accuracy of 98.13% and 96.92% for males and females respectively. According to the models, RDW and PLT were the most significant hematological factors for both males and females. WBC, PDW, and HCT for males and RBC, MCV, and MXD for females were also important. Some hematological factors associated with PVC were found using ML models. Further studies are needed to confirm these results in other populations, considering the novelty of the exploration of the relationship between hematological parameters and PVC.
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Affiliation(s)
- Nafiseh Hosseini
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Saffar Soflaei
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pooria Salehi-Sangani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdiyeh Yaghooti-Khorasani
- Radiation Oncology Research Center, Cancer Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Shahri
- Department of Cardiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Helia Rezaeifard
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Social Determinants of Health Research center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Mohsen Moohebati
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Xu R, Chen L, Yan C, Xu H, Cao G. Elevated Platelet-to-Lymphocyte Ratio as a Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Individuals. J Clin Hypertens (Greenwich) 2025; 27:e14980. [PMID: 39878317 PMCID: PMC11775908 DOI: 10.1111/jch.14980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 12/26/2024] [Accepted: 01/02/2025] [Indexed: 01/31/2025]
Abstract
The platelet-to-lymphocyte ratio (PLR) has been proposed as a promising inflammatory biomarker, with potential implications for cardiovascular prognosis. However, its association with mortality outcomes in hypertensive individuals is not fully elucidated. This investigation sought to clarify the linkage between PLR and both overall and cardiovascular mortality in hypertensive individuals. Data from 15 483 hypertensive adults in the NHANES (2005-2018) were analyzed. Mortality data, including all-cause and cardiovascular deaths, were sourced from the National Death Index (NDI) up to December 31, 2019. The linkage between PLR and mortality risk was depicted using restricted cubic spline (RCS) models. Cox proportional hazards regression models assessed the independent association of PLR with mortality risk, with adjustments incrementally applied: Model 1 without adjustments; Model 2 adjusted for age and sex; Model 3 adjusted further for age, gender, race, marital status, diabetes, alcohol intake, smoking status, body mass index (BMI), history of cardiovascular disease (CVD), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), total cholesterol (TC), triglyceride (TG), and creatinine (CR). Over a median follow-up of 79 months, there were 2820 all-cause deaths and 758 cardiovascular deaths. The multivariate Cox analysis showed that those in the highest PLR quartile had significantly elevated risks of all-cause mortality (Model 1: HR = 1.28, 95% CI 1.16-1.42, p < 0.001; Model 2: HR = 1.14, 95% CI 1.03-1.26, p = 0.014; Model 3: HR = 1.16, 95% CI 1.05-1.29, p = 0.004)and cardiovascular mortality (Model 1: HR = 1.59, 95% CI 1.30-1.94, p < 0.001; Model 2: HR = 1.38, 95% CI 1.13-1.68, p = 0.001; Model 3: HR = 1.47, 95% CI 1.20-1.80, p < 0.001). The study reveals a U-shaped relationship between PLR and all-cause mortality, alongside a linear association with cardiovascular mortality. A PLR threshold of 118.83 has been identified as indicative of an adverse prognosis for all-cause mortality. Elevated PLR independently predicts heightened risks of both all-cause and cardiovascular mortality among hypertensive patients.
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Affiliation(s)
- Rui Xu
- Gerontology CenterPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
- Department of CardiologyFifth Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina
| | - Ling Chen
- Gerontology CenterPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Changshun Yan
- Department of CardiologyFifth Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina
| | - Hong Xu
- Gerontology CenterPeople's Hospital of Xinjiang Uygur Autonomous RegionUrumqiXinjiangChina
| | - Guiqiu Cao
- Department of CardiologyFifth Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiangChina
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Li C, Chen J, Han D, Shu C, Huang J, Wei L, Luo H, Wu Q, Chen X, He Y, Zhou Y. Appraising non-linear association between pre-diagnostic platelet counts and cancer survival outcomes: observational and genetic analysis. Platelets 2024; 35:2379815. [PMID: 39072584 DOI: 10.1080/09537104.2024.2379815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 07/30/2024]
Abstract
Previous studies have reported inconsistent associations between platelet count (PLT) and cancer survival. However, whether there is linear causal effect merits in-depth investigations. We conducted a cohort study using the UK Biobank and a two-sample Mendelian randomization (MR) analysis. PLT levels were measured prior to cancer diagnosis. We adopted overall survival (OS) as the primary outcome. Cox models were utilized to estimate the effects of PLTs on survival outcomes at multiple lag times for cancer diagnosis. We employed 34 genetic variants as PLT proxies for MR analysis. Linear and non-linear effects were modeled. Prognostic effects of gene expression harboring the instrumental variants were also investigated. A total of 65 471 cancer patients were included. We identified a significant association between elevated PLTs (per 100 × 109/L) and inferior OS (HR: 1.07; 95% CI: 1.04-1.10; p < .001). Similar significant associations were observed for several cancer types. We further observed a U-shaped relationship between PLTs and cancer survival (p < .001). Our MR analysis found null evidence to support a causal association between PLTs and overall cancer survival (HR: 1.000; 95% CI: 0.998-1.001; p = .678), although non-linear MR analysis unveiled a potential greater detrimental effect at lower PLT range. Expression of eleven PLT-related genes were associated with cancer survival. Early detection of escalated PLTs indicated possible occult cancer development and inferior subsequent survival outcomes. The observed associations could potentially be non-linear. However, PLT is less likely to be a promising therapeutic target.
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Affiliation(s)
- Changtao Li
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Junhua Chen
- Department of General Surgery, West China Second Hospital, Sichuan University, Chengdu, China
| | - Deqian Han
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chi Shu
- Division of vascular surgery, Department of general surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jun Huang
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Linru Wei
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Haoran Luo
- Key Laboratory of the Ministry of Education for Coastal and Wetland Ecosystems, College of the Environment and Ecology, Xiamen University, Xiamen, Fujian, China
| | - Qingbin Wu
- Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Chen
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yazhou He
- Department of Oncology, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Yanhong Zhou
- Department of laboratory medicine, West China Hospital, Sichuan University, Chengdu, China
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Walther K, Gröger S, Vogler JAH, Wöstmann B, Meyle J. Inflammation indices in association with periodontitis and cancer. Periodontol 2000 2024; 96:281-315. [PMID: 39317462 PMCID: PMC11579835 DOI: 10.1111/prd.12612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 09/26/2024]
Abstract
Inflammation is a complex physiological process that plays a pivotal role in many if not all pathological conditions, including infectious as well as inflammatory diseases, like periodontitis and autoimmune disorders. Inflammatory response to periodontal biofilms and tissue destruction in periodontitis is associated with the release of inflammatory mediators. Chronic inflammation can promote the development of cancer. Persistence of inflammatory mediators plays a crucial role in this process. Quantification and monitoring of the severity of inflammation in relation to cancer is essential. Periodontitis is mainly quantified based on the severity and extent of attachment loss and/or pocket probing depth, in addition with bleeding on probing. In recent years, studies started to investigate inflammation indices in association with periodontal diseases. To date, only few reviews have been published focusing on the relationship between blood cell count, inflammation indices, and periodontitis. This review presents a comprehensive overview of different systemic inflammation indices, their methods of measurement, and the clinical applications in relation to periodontitis and cancer. This review outlines the physiological basis of inflammation and the underlying cellular and molecular mechanisms of the parameters described. Key inflammation indices are commonly utilized in periodontology such as the neutrophil to lymphocyte ratio. Inflammation indices like the platelet to lymphocyte ratio, platelet distribution width, plateletcrit, red blood cell distribution width, lymphocyte to monocyte ratio, delta neutrophil index, and the systemic immune inflammation index are also used in hospital settings and will be discussed. The clinical roles and limitations, relationship to systemic diseases as well as their association to periodontitis and treatment response are described.
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Affiliation(s)
- Kay‐Arne Walther
- Department of Periodontology, Dental ClinicJustus Liebig University of GiessenGiessenGermany
- Department of Prosthodontics, Dental ClinicJustus Liebig University of GiessenGiessenGermany
| | - Sabine Gröger
- Department of Periodontology, Dental ClinicJustus Liebig University of GiessenGiessenGermany
- Department of Orthodontics, Dental ClinicJustus Liebig University of GiessenGiessenGermany
| | | | - Bernd Wöstmann
- Department of Periodontology, Dental ClinicJustus Liebig University of GiessenGiessenGermany
- Department of Prosthodontics, Dental ClinicJustus Liebig University of GiessenGiessenGermany
| | - Jörg Meyle
- Department of Periodontology, Dental ClinicJustus Liebig University of GiessenGiessenGermany
- Department of Periodontology, Dental ClinicUniversity of BernBernSwitzerland
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Wang Q, Zhang G. Platelet count as a prognostic marker for acute respiratory distress syndrome. BMC Pulm Med 2024; 24:396. [PMID: 39153980 PMCID: PMC11330071 DOI: 10.1186/s12890-024-03204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the role of platelet count (PLT) in the prognosis of patients with acute respiratory distress syndrome (ARDS). METHODS The data were extracted from the Medical Information Mart for Intensive Care database (version 2.2). Patients diagnosed with ARDS according to criteria from Berlin Definition and had the platelet count (PLT) measured within the first day after intensive care unit admission were analyzed. Based on PLT, ARDS patients were divided into four groups: PLT ≤ 100 × 109/L, PLT 101-200 × 109/L, PLT 201-300 × 109/L, and PLT > 300 × 109/L. The primary outcome was 28-day mortality. Survival probabilities were analyzed using Kaplan-Meier. Furthermore, the association between PLT and mortality in ARDS patients was assessed using a univariate and multivariable Cox proportional hazards model. RESULTS Overall, the final analysis included 3,207 eligible participants with ARDS. According to the Kaplan-Meier curves for 28-day mortality of PLT, PLT ≤ 100 × 109/L was associated with a higher incidence of mortality (P = 0.001), the same trends were observed in the 60-day (P = 0.001) and 90-day mortality (P = 0.001). In the multivariate model adjusted for the potential factors, the adjusted hazard ratio at PLT 101-200 × 109/L group, PLT 201-300 × 109/L, and PLT > 300 × 109/L was 0.681 [95% confidence interval (CI): 0.576-0.805, P < 0.001], 0.733 (95% CI: 0.604-0.889, P = 0.002), and 0.787 (95% CI: 0.624-0.994, P = 0.044) compared to the reference group (PLT ≤ 100 × 109/L), respectively. Similar relationships between the PLT ≤ 100 × 109/L group and 28-day mortality were obtained in most subgroups. CONCLUSION PLT appeared to be an independent predictor of mortality in critically ill patients with ARDS.
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Affiliation(s)
- Qianwen Wang
- Department of Intensive care unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhe Jiang, 310000, China, No 3 East Road Qingchun
| | - Ge Zhang
- Department of Intensive care unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hang Zhou, Zhe Jiang, 310000, China, No 3 East Road Qingchun.
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7
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Neppala S, Chigurupati HD, Chauhan S, Chinthapalli MT, Desai R. Impact of depression on in-hospital outcomes for adults with type 2 myocardial infarction: A United States population-based analysis. World J Cardiol 2024; 16:412-421. [PMID: 39086894 PMCID: PMC11287453 DOI: 10.4330/wjc.v16.i7.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/30/2024] [Accepted: 06/25/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Type 2 myocardial infarction (T2MI) is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary event. However, though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction (T1MI), data remains non-existent to evaluate the association with T2MI. AIM To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital outcomes. METHODS We queried the National Inpatient Sample (2019) to identify T2MI hospitalizations using Internal Classification of Diseases-10 codes in hospitalized adults (≥ 18 years). In addition, we compared sociodemographic and comorbidities in the T2MI cohort with vs without comorbid depression. Finally, we used multivariate regression analysis to study the odds of T2MI hospitalizations with vs without depression and in-hospital outcomes (all-cause mortality, cardiogenic shock, cardiac arrest, and stroke), adjusting for confounders. Statistical significance was achieved with a P value of < 0.05. RESULTS There were 331145 adult T2MI hospitalizations after excluding T1MI (median age: 73 years, 52.8% male, 69.9% white); 41405 (12.5%) had depression, the remainder; 289740 did not have depression. Multivariate analysis revealed lower odds of T2MI in patients with depression vs without [adjusted odds ratio (aOR) = 0.88, 95% confidence interval (CI): 0.86-0.90, P = 0.001]. There was the equal prevalence of prior MI with any revascularization and a similar prevalence of peripheral vascular disease in the cohorts with depression vs without depression. There is a greater prevalence of stroke in patients with depression (10.1%) vs those without (8.6%). There was a slightly higher prevalence of hyperlipidemia in patients with depression vs without depression (56.5% vs 48.9%), as well as obesity (21.3% vs 17.9%). There was generally equal prevalence of hypertension and type 2 diabetes mellitus in both cohorts. There was no significant difference in elective and non-elective admissions frequency between cohorts. Patients with depression vs without depression also showed a lower risk of all-cause mortality (aOR = 0.75, 95%CI: 0.67-0.83, P = 0.001), cardiogenic shock (aOR = 0.65, 95%CI: 0.56-0.76, P = 0.001), cardiac arrest (aOR = 0.77, 95%CI: 0.67-0.89, P = 0.001) as well as stroke (aOR = 0.79, 95%CI: 0.70-0.89, P = 0.001). CONCLUSION This study revealed a significantly lower risk of T2MI in patients with depression compared to patients without depression by decreasing adverse in-hospital outcomes such as all-cause mortality, cardiogenic shock, cardiac arrest, and stroke in patients with depression.
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Affiliation(s)
- Sivaram Neppala
- Department of Internal Medicine, University of Texas at San Antonio, San Antonio, TX 78249, United States
| | - Himaja Dutt Chigurupati
- Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ 07102, United States
| | - Shaylika Chauhan
- Department of Internal Medicine, Geisinger Health System, Wikes-Barre, PA 18702, United States.
| | | | - Rupak Desai
- Independent Researcher, Atlanta, GA 30079, United States
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Fisher A, Fisher L, Srikusalanukul W. Prediction of Osteoporotic Hip Fracture Outcome: Comparative Accuracy of 27 Immune-Inflammatory-Metabolic Markers and Related Conceptual Issues. J Clin Med 2024; 13:3969. [PMID: 38999533 PMCID: PMC11242639 DOI: 10.3390/jcm13133969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 07/14/2024] Open
Abstract
Objectives: This study, based on the concept of immuno-inflammatory-metabolic (IIM) dysregulation, investigated and compared the prognostic impact of 27 indices at admission for prediction of postoperative myocardial injury (PMI) and/or hospital death in hip fracture (HF) patients. Methods: In consecutive HF patient (n = 1273, mean age 82.9 ± 8.7 years, 73.5% females) demographics, medical history, laboratory parameters, and outcomes were recorded prospectively. Multiple logistic regression and receiver-operating characteristic analyses (the area under the curve, AUC) were used to establish the predictive role for each biomarker. Results: Among 27 IIM biomarkers, 10 indices were significantly associated with development of PMI and 16 were indicative of a fatal outcome; in the subset of patients aged >80 years with ischaemic heart disease (IHD, the highest risk group: 90.2% of all deaths), the corresponding figures were 26 and 20. In the latter group, the five strongest preoperative predictors for PMI were anaemia (AUC 0.7879), monocyte/eosinophil ratio > 13.0 (AUC 0.7814), neutrophil/lymphocyte ratio > 7.5 (AUC 0.7784), eosinophil count < 1.1 × 109/L (AUC 0.7780), and neutrophil/albumin × 10 > 2.4 (AUC 0.7732); additionally, sensitivity was 83.1-75.4% and specificity was 82.1-75.0%. The highest predictors of in-hospital death were platelet/lymphocyte ratio > 280.0 (AUC 0.8390), lymphocyte/monocyte ratio < 1.1 (AUC 0.8375), albumin < 33 g/L (AUC 0.7889), red cell distribution width > 14.5% (AUC 0.7739), and anaemia (AUC 0.7604), sensitivity 88.2% and above, and specificity 85.1-79.3%. Internal validation confirmed the predictive value of the models. Conclusions: Comparison of 27 IIM indices in HF patients identified several simple, widely available, and inexpensive parameters highly predictive for PMI and/or in-hospital death. The applicability of IIM biomarkers to diagnose and predict risks for chronic diseases, including OP/OF, in the preclinical stages is discussed.
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Affiliation(s)
- Alexander Fisher
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra 2605, Australia
- Department of Orthopaedic Surgery, The Canberra Hospital, ACT Health, Canberra 2605, Australia
- Medical School, Australian National University, Canberra 2601, Australia
| | - Leon Fisher
- Frankston Hospital, Peninsula Health, Melbourne 3199, Australia
| | - Wichat Srikusalanukul
- Department of Geriatric Medicine, The Canberra Hospital, ACT Health, Canberra 2605, Australia
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Inci SD, Gunduz H, Gunduz Y. The role of inflammation markers in occurrence of radial artery occlusion. Biomark Med 2024; 18:399-406. [PMID: 39041846 DOI: 10.1080/17520363.2024.2345582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 04/17/2024] [Indexed: 07/24/2024] Open
Abstract
Aim: Radial artery occlusion (RAO) is a major complication of catheterization via transradial access (TRA). Our aim is to reveal the ability of high-sensitive C-reactive protein (hs-CRP) and complete blood count (CBC) components, which are inflammation markers, to predict RAO. Methods: Patients were divided into two groups: 103 with RAO and 300 without RAO. The relationship between CRP, CBC components and RAO was evaluated. Results: A significant increase in hs-CRP, monocyte, platelet (PLT), platelet distribution width (PDW) and plateletcrit values was observed after TRA, and only the increase in PDW, PLT and hs-CRP was found to be independent determinants in regression analysis. Conclusion: High PDW and PLT and increased hs-CRP levels are new independent determinants of the development of RAO.
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Affiliation(s)
- Saadet Demirtas Inci
- Cardiologist, University of Health Sciences Ankara Etlik City Hospital, Cardiology Department, Sakarya, 06170, Turkey
| | - Huseyin Gunduz
- Sakarya University Education & Research Hospital, Radiology Department, Sakarya, 06170, Turkey
| | - Yasemin Gunduz
- Sakarya University Education & Research Hospital, Radiology Department, Sakarya, 06170, Turkey
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10
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Franchin M, Muscato P, Piffaretti G, Tozzi M. Systemic inflammation index as useful tool to predict arteriovenous graft stenosis: Our experience and literature review. J Vasc Access 2024; 25:474-480. [PMID: 35996310 DOI: 10.1177/11297298221119595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Many studies show that settings of severe inflammatory stress might be responsible for changes in circulating blood cells count. Effective inflammation indices are created calculating the quantitative relationship between these cells. No previous studies have been proposed on hemodialysis patients exploring the association between arteriovenous graft (AVG) stenosis and systemic inflammation markers, such as Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic-immune-inflammation index (SII). METHODS Patients undergone surgery for AVG creation in a 2-year period are examined. Examining their full blood count, we have established the value of inflammatory indices (NLR, PLR, SII) and we have compared their mean values in patients who have developed significant stenosis or not. Finally, we have considered the connection between those values and stenosis onset and recurrence in AVG. RESULTS Fifty-two patients are included in the study [male: 40%, mean age 70 ± 15 years (range 55-86)]. We have found out there is not statistical significance in preoperative values of inflammatory index (NLR p 0.33, PLR p 0.15, SII p 0.98) Otherwise NLR and SII indices were statistically significant 3 months after surgery (NLR 2.04 ± 0.98 vs 3.91 ± 2.10, p < 0.001; SII 415.32 ± 255.15 vs 636.91 ± 349.01, p 0.014). CONCLUSIONS Increased post-operative values of NLR and SII have proved a strong association with AVG outflow stenosis onset and recurrence.
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Affiliation(s)
- Marco Franchin
- Vascular Surgery, University of Insubria, Asst-settelaghi Universitary Teaching Hospital, Varese, Italy
| | - Paola Muscato
- Vascular Surgery, University of Insubria, Asst-settelaghi Universitary Teaching Hospital, Varese, Italy
| | - Gabriele Piffaretti
- Vascular Surgery, University of Insubria, Asst-settelaghi Universitary Teaching Hospital, Varese, Italy
| | - Matteo Tozzi
- Vascular Surgery, University of Insubria, Asst-settelaghi Universitary Teaching Hospital, Varese, Italy
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11
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Hao P, Feng S, Suo M, Wang S, Wu X. Platelet to albumin ratio: A risk factor related to prognosis in patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention. Int J Cardiol 2024; 395:131588. [PMID: 37989451 DOI: 10.1016/j.ijcard.2023.131588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/26/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Atherosclerotic cardiovascular disease (ASCAD) is recognized as a chronic subclinical systemic inflammatory condition. The platelet-albumin ratio (PAR) has shown promise in prognosticating various inflammation-related disorders. Our study aimed to assess the connection between PAR and major adverse cardiovascular events (MACE) in percutaneous coronary intervention (PCI)-treated patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS PAR, derived from platelet and albumin counts, categorized participants into four quartiles. The primary outcome was composite MACE, encompassing all-cause mortality, non-fatal myocardial infarction (MI), and ischemia-driven revascularization. Secondary outcomes comprised individual MACE components. Multivariate Cox regression evaluated PAR's independent impact on adverse events. The non-linear relationship between the PAR value and MACE was explored using a restricted cubic spline (RCS). Receiver operating characteristic (ROC) analysis was conducted and the area under the curve (AUC) was calculated. Subgroup analysis was used to determine the effect of PAR on MACE in different subgroups. RESULTS Enrolling 1391 NSTE-ACS patients, high PAR quartiles were correlated with elevated MACE rates (quartile 4 vs. quartile 1: 33.5% vs. 10.2%, p < 0.001). PAR was revealed to be independently related to an increased risk of MACE (quartile 4 vs. quartile 1: HR, 2.04 [95% CI, 1.34-3.08], p = 0.001). RCS indicated a positive PAR-MACE relationship. The AUC of PAR for the 3-year MACE was 0.659 (95% CI: 0.626-0.677, P<0.001). Subgroup analysis showed no significant interactions across subsets. CONCLUSION PAR independently predicted MACE risk in PCI-treated NSTE-ACS patients.
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Affiliation(s)
- Peng Hao
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Siting Feng
- Emergency & Critical Care Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Min Suo
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Shen Wang
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xiaofan Wu
- Integrated Ward of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
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12
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Feng R, Dai Y, Du S, Liang W, Chen H, Chen C, He T, Tao T, Hu Z, Guo P, Ye W. Leukocyte and Platelet Related Inflammatory Indicators and Risk of Carotid and Femoral Plaques: A Population-Based Cross-Sectional Study in Southeast China. Angiology 2024; 75:79-89. [PMID: 36175416 DOI: 10.1177/00033197221129723] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The associations between several blood inflammatory indicators and risk of vascular plaques remain inconclusive. A total of 4596 native rural residents in Southeast China were enrolled from the Fuqing cohort study. Blood cell counts and their composite indexes including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and 2 novel indicators (systemic immune inflammation index (SII) and systemic immune inflammation response index (SIRI)) were considered as inflammatory indicators. Common carotid and femoral intima-media thickness (IMT) and plaques were assessed using B-mode ultrasound. Unconditional or multinomial logistic regression was used to evaluate potential associations. The prevalence of multiple femoral plaques (defined as IMT ≥1.5 mm) was significantly higher among participants with the highest tertile of total leukocyte count (odds ratio, 1.78), neutrophil count (1.88), monocyte count (2.51), platelet count (1.68), NLR (1.93), PLR (1.57), SII (2.10), and SIRI (2.94). Higher levels of neutrophil count, platelet count, NLR, and SII were also found to have significant linear dose-response relationships with the prevalence of stenosis, especially in femoral arteries. In conclusion, several blood inflammatory biomarkers may contribute to, or are associated with, the presence of IMT ≥1.5 mm or stenosis especially in femoral arteries.
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Affiliation(s)
- Ruimei Feng
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yiquan Dai
- Department of Vascular Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Shanshan Du
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Wenbin Liang
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Hongyu Chen
- Department of Vascular Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Cheng Chen
- Department of Vascular Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Tianmin He
- Department of Vascular Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Tao Tao
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Zhijian Hu
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Pingfan Guo
- Department of Vascular Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Weimin Ye
- School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Chen C, Tang X, Fan P. Platelet-to-Lymphocyte Ratio as an Independent Factor Associated With Atrial Tachyarrhythmia. Cureus 2023; 15:e46775. [PMID: 37954762 PMCID: PMC10632768 DOI: 10.7759/cureus.46775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 11/14/2023] Open
Abstract
Objective To investigate the relationship between the presence of atrial tachyarrhythmia (AT) and the platelet-to-lymphocyte ratio (PLR), which is a recently described inflammatory marker. Methods A total of 149 patients with AT and 187 healthy volunteers were included in this study. Complete blood count, serum lipids, and serum creatinine were tested, and dynamic electrocardiograms were performed routinely in all subjects. Student's t-test, Mann-Whitney U test, logistic regression analysis, and receiver operating characteristic curve analysis were used for statistical analysis. Results In the AT group, the proportions of patients with diabetes, hypertension, and coronary heart disease were higher than those in the control group. Higher blood platelet, low-density lipoprotein, neutrophil-to-lymphocyte ratio, and PLR were detected in the AT group. In addition, haemoglobin, lymphocytes, and the fastest ventricular rate were significantly lower in the AT group. Higher PLR was identified as independently associated with the presence of AT. When a cut-off value of 119.47 was used, the sensitivity and specificity of PLR for predicting AT were 79.2% and 81.3%, respectively. Conclusion Elevated PLR was associated with AT, suggesting that it might be useful in the future as an adjunct biomarker for the detection of the disease.
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Affiliation(s)
- Cheng Chen
- Department of Medical Sciences, Yangzhou Polytechnic College, Yangzhou, CHN
| | - Xinyan Tang
- Department of Family Medicine, Jiangsu Vocational College of Medicine, Yancheng, CHN
| | - Ping Fan
- Department of Cardiology, The Air Force Hospital From Eastern Theater of the People's Liberation Army, Nanjing, CHN
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Tani S, Atsumi W, Yagi T, Imatake K, Suzuki Y, Takahashi A, Monden M, Matsumoto N, Okumura Y. Higher frequency of fish intake and healthy lifestyle behaviors may be associated with a lower platelet count in Japan: Implication for the anti-atherosclerotic effect of fish intake. Prev Med 2023; 175:107682. [PMID: 37625651 DOI: 10.1016/j.ypmed.2023.107682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Habitual fish intake and healthier lifestyles are associated with a lower risk of atherosclerotic cardiovascular disease (ASCVD). Higher platelet counts (PLCs) are reportedly associated with higher ASCVD events. We aimed to investigate the association between fish intake and lifestyle with PLCs. METHODS We conducted a cross-sectional study in a cohort of 9329 participants (average age: 46.9 ± 12.9 years; 58.9% men) with no history of ASCVD registered at the Health Planning Center of Nihon University Hospital in 2019. RESULTS The average fish intake frequency was 2.15 ± 1.28 days/week. As fish intake frequency increased (0, 1, 2, 3, 4, 5, 6, and 7 days), PLC decreased significantly (p < 0.0001). Multivariable logistic regression analysis showed that higher fish intake frequency tended to be a determinant of lower PLC. Aerobic exercise habits and sleep duration were independent negative determinants of PLC. Cigarette smoking habits were a positive independent determinant of PLC. Furthermore, with increasing fish intake frequency, the proportion of participants with habitual aerobic exercise, non-smoking habits, and longer sleep duration increased (p < 0.0001 for all). Higher n-3 polyunsaturated fatty acid (n-3 PUFA), calculated based on data from the Japanese National Health and Nutrition Survey, intake was associated with a lower PLC. CONCLUSION Higher fish intake and healthier lifestyle behaviors may be comprehensively associated with lower PLCs. The intake of N-3 PUFA with anti-inflammatory effects, rich in fish, may also be related to the lower PLC. This association may explain the preventive effects of fish intake on ASCVD risk.
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Affiliation(s)
- Shigemasa Tani
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan.
| | - Wataru Atsumi
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Tsukasa Yagi
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Kazuhiro Imatake
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Yasuyuki Suzuki
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Atsuhiko Takahashi
- Department of Health Planning Center, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan
| | - Masaki Monden
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Naoya Matsumoto
- Department of Cardiology, Nihon University Hospital, 1-6 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
| | - Yasuo Okumura
- Department of Medicine, Division of Cardiology, Nihon University School of Medicines, 30-1 Oyaguchi-kamimachi, Itabashi-ku, 173-8610 Tokyo, Japan
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15
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Liu F, Yang P, Wang Y, Shi M, Wang R, Xu Q, Peng Y, Chen J, Zhang J, Wang A, Xu T, Zhang Y, He J. HS-CRP Modifies the Prognostic Value of Platelet Count for Clinical Outcomes After Ischemic Stroke. J Am Heart Assoc 2023:e030007. [PMID: 37449575 PMCID: PMC10382093 DOI: 10.1161/jaha.123.030007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/24/2023] [Indexed: 07/18/2023]
Abstract
Background We examined whether the relationship between baseline platelet count and clinical outcomes is modulated by HS-CRP (high-sensitivity C-reactive protein) in patients with ischemic stroke. Methods and Results A total of 3267 patients with ischemic stroke were included in the analysis. The primary outcome was a combination of death and major disability at 1 year after ischemic stroke. Secondary outcomes included major disability, death, vascular events, composite outcome of vascular events or death, and an ordered 7-level categorical score of the modified Rankin Scale at 1 year. Multivariate logistic regression and Cox proportional hazards regression models were used to assess the association between the baseline platelet count and clinical outcomes stratified by HS-CRP levels when appropriate. There was an interaction effect of platelet count and HS-CRP on the adverse clinical outcomes after ischemic stroke (all Pinteraction<0.05). The elevated platelet count was significantly associated with the primary outcome (odds ratio [OR], 3.14 [95% CI, 1.77-5.58]), major disability (OR, 2.07 [95% CI, 1.15-3.71]), death (hazard ratio [HR], 2.75 [95% CI, 1.31-5.79]), and composite outcome of vascular events or death (HR, 2.57 [95% CI, 1.38-4.87]) among patients with high HS-CRP levels (all Ptrend<0.05). Conclusions The HS-CRP levels had a modifying effect on the association between platelet count and clinical outcomes in patients with ischemic stroke. Elevated platelet count was significantly associated with adverse clinical outcomes in patients with ischemic stroke with high HS-CRP levels, but not in those with low HS-CRP levels. These findings suggest that strategies for anti-inflammatory and antiplatelet therapy should be developed according to the results of both platelet and HS-CRP testing.
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Affiliation(s)
- Fanghua Liu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Yinan Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
| | - Ruirui Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Qingyun Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Yanbo Peng
- Department of Neurology Affiliated Hospital of North China University of Science and Technology Tangshan Hebei China
| | - Jing Chen
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
- Department of Medicine Tulane University School of Medicine New Orleans LA
| | - Jintao Zhang
- Department of Neurology The 960th Hospital of People's Liberation Army Jinan Shandong China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Suzhou Medical College of Soochow University Suzhou China
| | - Jiang He
- Department of Epidemiology Tulane University School of Public Health and Tropical Medicine New Orleans LA
- Department of Medicine Tulane University School of Medicine New Orleans LA
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16
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Madineni KU, Prasad SVN, Bhuma V. A study of the prognostic significance of platelet distribution width, mean platelet volume, and plateletcrit in cerebral venous sinus thrombosis. J Neurosci Rural Pract 2023; 14:418-423. [PMID: 37692829 PMCID: PMC10483190 DOI: 10.25259/jnrp-2021-1-3-r2-(1431)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Platelets play a key role in thrombus formation and propagation and are thus implicated in the pathogenesis and morbidity of cerebral venous sinus thrombosis (CVST). A whole blood count can be used to objectively measure platelet function through platelet indices, namely, platelet distribution width (PDW), mean platelet volume (MPV), and plateletcrit. This study examined how platelet indices (PDW,MPV, and plateletcrit) affect the CVST severity and functional outcome. Materials and Methods In this prospective, longitudinal, and observational study, 66 patients with CVST from a tertiary care referral center were enrolled. A complete blood count including platelet indices was obtained using an automated hematology analyzer. Patients with and without parenchymal abnormalities on brain imaging were classified as having severe and non-severe CVST, respectively. The modified Rankin Scale (mRS) was used to examine functional outcomes at admission and after 90 days. The patients were categorized into low mRS (0-1) and high mRS (2-6) functional groups. Results The patients with severe CVST were older (P < 0.05) and exhibited abnormally large PDW (P < 0.05) which were statistically significant. Severe CSVT also had poor functional outcome score both at admission (P < 0.05) and 90 days later (P < 0.05) which were statistically significant. Multiple logistic regression analysis concluded age and PDW as the independent predictors of severe CVST (P < 0.05). In receiver operating characteristic curve analysis, a cutoff value of 16.5 for PDW could predict CVST severity (P < 0.05). Patients with high mRS scores at admission had significantly larger PDW. At 90 days, no association was noted between PDW and mRS scores. MPV and plateletcrit levels were similar in both the severe and non-severe CVST groups and exerted no effect on functional outcomes. PDW was significantly and inversely related to plateletcrit (P < 0.05). Conclusion Severe CVST and PDW had a positive correlation. During the early phases of admission, PDW levels above a particular threshold were associated with poor functional outcomes; however, no such association was observed after 90 days. MPV and plateletcrit exerted no effect on CVST severity and prognosis.
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Affiliation(s)
- Komal Usha Madineni
- Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - S. V. Naveen Prasad
- Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Vengamma Bhuma
- Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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17
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Xiu J, Lin X, Chen Q, Yu P, Lu J, Yang Y, Chen W, Bao K, Wang J, Zhu J, Zhang X, Pan Y, Tu J, Chen K, Chen L. The aggregate index of systemic inflammation (AISI): a novel predictor for hypertension. Front Cardiovasc Med 2023; 10:1163900. [PMID: 37265570 PMCID: PMC10229810 DOI: 10.3389/fcvm.2023.1163900] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/24/2023] [Indexed: 06/03/2023] Open
Abstract
Objective Inflammation plays an important role in the pathophysiology of hypertension (HTN). Aggregate index of systemic inflammation (AISI), as a new inflammatory and prognostic marker has emerged recently. Our goal was to determine whether there was a relationship between HTN and AISI. Methods We analyzed patients with HTN from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. The primary end point was cardiovascular mortality. A total of 23,765 participants were divided into four groups according to the AISI quartile level. The association between AISI and cardiovascular mortality in patients with HTN was assessed by survival curves and Cox regression analyses based on NHANES recommended weights. Results High levels of AISI were significantly associated with cardiovascular mortality in patients with HTN. After full adjustment for confounders, there was no significant difference in the risk of cardiovascular mortality in Q2 and Q3 compared to Q1, while Q4 (HR: 1.91, 95% CI: 1.42-2.58; P < 0.001) had a higher risk of cardiovascular mortality compared to Q1. Results remained similar in subgroup analyses stratified by age (P for interaction = 0.568), gender (P for interaction = 0.059), and obesity (P for interaction = 0.289). Conclusions In adults with HTN, elevated AISI levels are significantly associated with an increased risk of cardiovascular mortality and may serve as an early warning parameter for poor prognosis.
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Affiliation(s)
- Jiaming Xiu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Xueqin Lin
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Qiansheng Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Pei Yu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Jin Lu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Yanfang Yang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Weihua Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Kunming Bao
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Junjie Wang
- Department of Cardiology, Fuzhou First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Jinlong Zhu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Xiaoying Zhang
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Yuxiong Pan
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Jiabin Tu
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Kaihong Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
| | - Liling Chen
- Department of Cardiology, Longyan First Affiliated Hospital of Fujian Medical University, Longyan, China
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18
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Huang R, Zhang L, Li X, Liu F, Cheng X, Ran H, Wang Z, Li Y, Feng Y, Liang L, Su W, Melgiri ND, Sun Y. Anti-CXCR2 antibody-coated nanoparticles with an erythrocyte-platelet hybrid membrane layer for atherosclerosis therapy. J Control Release 2023; 356:610-622. [PMID: 36898531 DOI: 10.1016/j.jconrel.2023.02.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/20/2023] [Accepted: 02/26/2023] [Indexed: 03/12/2023]
Abstract
Atherosclerosis is the leading cause of mortality globally. RBC-platelet hybrid membrane-coated nanoparticles ([RBC-P]NPs), which biologically mimic platelets in vivo, display evidence of anti-atherosclerotic activity. The efficacy of a targeted RBC-platelet hybrid membrane-coated nanoparticles ([RBC-P]NP)-based approach was investigated as a primary preventive measure against atherosclerosis. A ligand-receptor interactome analysis conducted with circulating platelets and monocytes derived from CAD patients and healthy controls identified CXCL8-CXCR2 as a key platelet ligand-monocyte receptor dyad in CAD patients. Based on this analysis, a novel anti-CXCR2 [RBC-P]NP that specifically binds to CXCR2 and blocks the interaction between CXCL8 and CXCR2 was engineered and characterized. Administering anti-CXCR2 [RBC-P]NPs to Western diet-fed Ldlr-/- mice led to diminished plaque size, necrosis, and intraplaque macrophage accumulation relative to control [RBC-P]NPs or vehicle. Importantly, anti-CXCR2 [RBC-P]NPs demonstrated no adverse bleeding/hemorrhagic effects. A series of in vitro experiments was conducted to characterize anti-CXCR2 [RBC-P]NP's mechanism of action in plaque macrophages. Mechanistically, anti-CXCR2 [RBC-P]NPs inhibited p38α (Mapk14)-mediated, pro-inflammatory M1 skewing and corrected efferocytosis in plaque macrophages. This targeted [RBC-P]NP-based approach, in which the cardioprotective effects of anti-CXCR2 [RBC-P]NP therapy overweighs its bleeding/hemorrhagic risks, could potentially be used to proactively manage atherosclerotic progression in at-risk populations.
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Affiliation(s)
- Rongzhong Huang
- Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing 400010, China
| | - Lujun Zhang
- Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xingsheng Li
- Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing 400010, China
| | - Fan Liu
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China
| | - Xiaoxiao Cheng
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China
| | - Haitao Ran
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China
| | - Zhigang Wang
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China
| | - Yongyong Li
- Precision Medicine Center, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Municipality Clinical Research Center for Geriatrics and Gerontology, Chongqing 400010, China
| | - Yuxing Feng
- Department of Rehabilitation and Pain Medicine, The Ninth People's Hospital of Chongqing, Chongqing, China
| | - Liwen Liang
- Department of Cardiology, The First People's Hospital of Yunnan Province, Kunming, China
| | - Wenhua Su
- Department of Cardiology, The First People's Hospital of Yunnan Province, Kunming, China
| | - N D Melgiri
- Impactys Foundation for Biomedical Research, San Diego, CA, USA
| | - Yang Sun
- Department of Ultrasound, The Second Affiliated Hospital of Chongqing Medical University, Chongqing Key Laboratory of Ultrasound Molecular Imaging, Chongqing, China.
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Platelet Reactivity and Cardiovascular Mortality Risk in the LURIC Study. J Clin Med 2023; 12:jcm12051913. [PMID: 36902699 PMCID: PMC10003439 DOI: 10.3390/jcm12051913] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/14/2023] [Accepted: 02/20/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND The clinical and prognostic implications of platelet reactivity (PR) testing in a P2Y12-inhibitor naïve population are poorly understood. OBJECTIVES This explorative study aims to assess the role of PR and explore factors that may modify elevated mortality risk in patients with altered PR. METHODS Platelet ADP-induced CD62P and CD63 expression were measured by flow-cytometry in 1520 patients who were referred for coronary angiography in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC). RESULTS High- and Low-platelet reactivity to ADP were strong predictors of cardiovascular and all-cause mortality and risk equivalent to the presence of coronary artery disease. (High platelet reactivity 1.4 [95% CI 1.1-1.9]; Low platelet reactivity: 1.4 [95% CI 1.0-2.0]). Relative weight analysis indicated glucose control (HbA1c), renal function ([eGFR]), inflammation (high-sensitive C-reactive protein [hsCRP]) and antiplatelet therapy by Aspirin as consistent mortality risk modifiers in patients with Low- and High-platelet reactivity. Pre-specified stratification of patients by risk modifiers HbA1c (<7.0%), eGFR (>60 mL/min/1.73 m2) and CRP (<3 mg/L) was associated with a lower mortality risk, however irrespective of platelet reactivity. Aspirin treatment was associated with reduced mortality in patients with high platelet reactivity only (p for interaction: 0.02 for CV-death [<0.01 for all-cause mortality]. CONCLUSIONS Cardiovascular mortality risk in patients with High- and Low platelet reactivity is equivalent to the presence of coronary artery disease. Targeted glucose control, improved kidney function and lower inflammation are associated with reduced mortality risk, however independent of platelet reactivity. In contrast, only in patients with High-platelet reactivity was Aspirin treatment associated with lower mortality.
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Qiu F, Zhang H, He Y, Liu H, Zheng T, Xia W, Xu S, Zhou J, Li Y. Associations of arsenic exposure with blood pressure and platelet indices in pregnant women: A cross-sectional study in Wuhan, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114378. [PMID: 36525950 DOI: 10.1016/j.ecoenv.2022.114378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/14/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental inorganic arsenic (iAs) exposure is potentially related to abnormal blood pressure (BP) changes and abnormal platelet activation. However, limited epidemiological studies have explored the impacts of iAs exposure on platelet change mediated by BP, especially for pregnant women. OBJECTIVES Our purpose was to investigate the associations of arsenic exposure with blood pressure and platelet indices among pregnant women. METHODS The present study population included 765 pregnant women drawn from a prospective birth cohort study in Wuhan, China, recruited between October 2013 and April 2016. Urine sampled in the second trimester were used to assess arsenic species concentrations. The relative distribution of urinary arsenic species was used to measure human methylation capacity. BP parameters and platelet indices originated from the medical record. We applied multivariable linear regression models to explore the cross-sectional relationships between urinary arsenic metabolites, BP parameters, and platelet indices. We utilized mediation analysis to investigate the impacts of arsenic exposure on platelet indices through BP as mediator variables. RESULTS We observed significant positive correlations between iAs and systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Pregnant women with higher methylation capacity to metabolize iAs characterized by higher secondary methylation index (SMI) and total methylation index (TMI) had a more significant reduction in SBP, DBP, and MAP. Pregnant women with higher DBP and MAP had higher platelet counts (PLC). A decreased PLC was found in subjects wither higher SMI. Additionally, SMI was negatively linked to PLC mediated through MAP. CONCLUSIONS Obtained results suggested that higher methylation capacity to metabolize iAs might contribute to decreased PLC among pregnant women, and MAP might mediate the influence of SMI on PLC.
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Affiliation(s)
- Feng Qiu
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | - Yujie He
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieqiong Zhou
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Department of Gynaecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yuanyuan Li
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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21
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Zheng C, Ge Q, Luo C, Hu L, Shen Y, Xue Q. Enteral nutrition improves the prognosis and immune nutritional status of patients in the cardiothoracic surgery recovery unit: A propensity score-matched analysis. Clin Nutr 2022; 41:2699-2705. [PMID: 36343561 DOI: 10.1016/j.clnu.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/01/2022] [Accepted: 10/14/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND It remains unclear whether enteral nutrition (EN) has an impact on prognosis and immune nutritional status for patients in the cardiothoracic surgery recovery unit (CSRU). We hypothesized that only patients with specific characteristics would benefit from EN and aimed to distinguish that specific population by examining a large database. METHODS Propensity-score matching (PSM) was used to eliminate the baseline imbalances between the EN and non-EN groups. The modified nutritional risk in the critically ill (mNUTRIC) score was used to assess the severity of patients' disease as well as their nutritional risk. Kaplan-Meier curves were used to compare the differences in 28- and 1000-day overall survival in the two groups after PSM. Generalized additive mixed models (GAMMs) were used to show dynamic changes in neutrophil-to-lymphocyte ratios (NLRs) and platelet-to-lymphocyte ratios (PLRs) in the two groups. Subgroup analysis was used to identify the specific population that could benefit from EN. RESULTS A total of 1823 patients (EN group, n = 395; non-EN group, n = 1428) were enrolled; after PSM, 320 pairs of patients remained. EN was found to reduce the 28-day mortality rate (adjusted hazard ratio [HR] = .56; 95% CI, .35-.91; P = .019) of patients, whereas it had no effect on 1000-day survival (adjusted HR = .97; 95% CI, .75-1.25; P = .797). Subgroup analyses indicated that patients with mNUTRIC equal to or greater than 4, body mass index (BMI) 25-30 kg/m2, and vasopressor support were more likely to benefit from EN. NLR and PLR in the EN group decreased progressively over time compared with the non-EN group, suggesting that EN might improve clinical outcomes by regulating immune and inflammatory responses. CONCLUSION EN may improve the prognosis and immune nutritional status of patients in the CSRU. Patients who might benefit should be actively treated with EN.
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Affiliation(s)
- Chao Zheng
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China; Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Qiyue Ge
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chao Luo
- Department of Cardiothoracic Surgery, Jinling Hospital, Southern Medical University, Guangzhou, China
| | - Liwen Hu
- Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Yi Shen
- Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China; Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Qi Xue
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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22
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Seo IH, Lee YJ. Usefulness of Complete Blood Count (CBC) to Assess Cardiovascular and Metabolic Diseases in Clinical Settings: A Comprehensive Literature Review. Biomedicines 2022; 10:2697. [PMID: 36359216 PMCID: PMC9687310 DOI: 10.3390/biomedicines10112697] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/07/2022] [Accepted: 10/20/2022] [Indexed: 08/03/2023] Open
Abstract
Complete blood count (CBC) is one of the most common blood tests requested by clinicians and evaluates the total numbers and characteristics of cell components in the blood. Recently, many investigations have suggested that the risk of cancer, cardiovascular disease (CVD), arteriosclerosis, type 2 diabetes (T2DM), and metabolic syndrome can be predicted using CBC components. This review introduces that white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), hemoglobin (Hb), mean corpuscular volume (MCV), red cell distribution width (RDW), platelet count, mean platelet volume (MPV), and platelet-to-lymphocyte ratio (PLR) are useful markers to predict CVD and metabolic diseases. Furthermore, we would like to support various uses of CBC by organizing pathophysiology that can explain the relationship between CBC components and diseases.
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23
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Dhar I, Svingen GFT, Pedersen EKR, Ulvik A, Bjørnestad EØ, Dankel SN, Mellgren G, Nygård OK. Physical activity and risk of all-cause mortality in patients with stable angina pectoris: Effect modification by β-blocker treatment. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2022; 15:200150. [PMID: 36573185 PMCID: PMC9789355 DOI: 10.1016/j.ijcrp.2022.200150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/22/2022] [Accepted: 09/05/2022] [Indexed: 12/30/2022]
Abstract
Background Physical activity (PA) influences sympathetic stimulation, platelet activation as well as vascular function, and has been associated with improved health outcomes in patients with coronary heart disease. β-blocker therapy reduces sympathetic activity and improves platelet and endothelial function. We investigated if β-blocker treatment modifies the association of self-reported PA with the risk of all-cause mortality. Methods A total of 2284 patients undergoing elective coronary angiography for suspected stable angina pectoris (SAP) were studied. Using Cox modeling, we examined associations between PA (categorized as 'sedentary/inactive', 'low', 'moderate', and 'high') and all-cause mortality according to β-blocker therapy. Results During a median follow-up of 10.3 years, 390 patients (17.1%) died. Higher PA was generally associated with a more favorable cardiovascular risk profile. Compared to the patients who were sedentary or inactive, the age and sex adjusted HRs (95% CI) for all-cause mortality were 0.89 (0.66-1.20), 0.73 (0.57-0.95) and 0.72 (0.55-0.95) in the low, moderate and high PA group, respectively. However, and notably, these risk estimates were 0.85 (0.60-1.20), 0.65 (0.47-0.89) and 0.58 (0.41-0.81) in β-blocker treated subjects vs. 1.00 (0.57-1.78), 0.96 (0.61-1.52) and 1.20 (0.74-1.95) in non-treated groups (P interaction = 0.018). The results were essentially similar in the multivariable adjusted models. Conclusions In patients with suspected SAP, increased PA was associated with reduced mortality risk primarily in patients treated with β-blockers.
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Affiliation(s)
- Indu Dhar
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Corresponding author. Department of Clinical Science, University of Bergen, Laboratory Building, 9th floor, Haukeland University Hospital, Jonas Lies vei 87, Bergen N‐5021, Norway.
| | - Gard FT. Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva KR. Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | | | - Simon N. Dankel
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Gunnar Mellgren
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Hormone Laboratory, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Ottar K. Nygård
- Mohn Nutrition Research Laboratory, Department of Clinical Science, University of Bergen, Bergen, Norway,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
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Casanova N, Diaz-Duran C, Nieto L, Llort C, Elosua R, Clara A. Predictive Value of Complete Blood Count-Derived Inflammatory Markers for 5-Year Survival After Carotid Endarterectomy: Implications for Practice. Angiology 2022; 73:675-681. [PMID: 35089092 DOI: 10.1177/00033197211067581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Complete blood count inflammatory markers (CBC-IMs) have been associated with cardiovascular diseases and mortality. We aimed to evaluate the relationship between preoperative CBC-IMs and 5-year survival after carotid endarterectomy (CEA). Retrospective analysis of 411 consecutive patients who underwent CEA between 2004 and 2018 was done. CBC-IM included the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte (LMR) ratio, and systemic immune-inflammation index (SII). Survival rate at 5 years was 79.8%. Age (hazard ratio (HR) = 1.05, P = .003), hemoglobin (HR = 0.78, P < .001), heart failure (HR = 2.91, P = .005), American Society of Anesthesiologists (ASA)-IV score (HR = 2.41, P = .043), and active neoplastic disease (HR = 2.61, P = .028) were independently related to survival. The discrimination of this model (C-statistic) was 0.698. Spline analysis showed a linear relationship between survival and NLR (P < .001), PLR (P < .001), and SII (P < .001). After adjusting for the baseline predictive score, there was a significant relationship between survival and NLR (HR = 1.191, P = .001), PLR (HR = 1.004, P = .017), and SII (HR = 1.001, P < .001). The addition of NLR, PLR, and SII to the survival model improved the continuous net reclassification index (c-NRI) by 0.29 (P = .028), 0.347 (P = .008), and 0.481 (P < .001), respectively, but not the C-statistic. CBC-IMs show a linear and independent relationship with 5-year survival after CEA and may moderately contribute to patient selection for this preventive intervention.
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Affiliation(s)
- Núria Casanova
- Vascular Surgery Department, 16548Hospital del Mar, Barcelona, Spain.,Universitat Autònoma de Barcelona/Universitat Pompeu Fabra, Barcelona, Spain
| | - Carles Diaz-Duran
- Vascular Surgery Department, 16548Hospital del Mar, Barcelona, Spain
| | - Lluís Nieto
- Vascular Surgery Department, 16548Hospital del Mar, Barcelona, Spain
| | - Carme Llort
- Vascular Surgery Department, 16548Hospital del Mar, Barcelona, Spain
| | - Roberto Elosua
- Cardiovascular Epidemiology and Genetics, 16551IMIM (Hospital del Mar Research Institute), Barcelona, Spain.,CIBER Cardiovascular, Barcelona, Spain.,Universitat de Vic - Universitat Central de Catalunya, Barcelona, Spain
| | - Albert Clara
- Vascular Surgery Department, 16548Hospital del Mar, Barcelona, Spain.,Universitat Autònoma de Barcelona/Universitat Pompeu Fabra, Barcelona, Spain.,CIBER Cardiovascular, Barcelona, Spain
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25
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Kosugi S, Ueda Y, Abe H, Ikeoka K, Mishima T, Ozaki T, Takayasu K, Ohashi T, Yamane H, Nakamura M, Fukushima T, Horiuchi K, Iehara T, Osaki S, Ozato K, Inoue K, Koretsune Y, Matsumura Y. Temporary Rise in Blood Thrombogenicity in Patients with Acute Myocardial Infarction. TH OPEN : COMPANION JOURNAL TO THROMBOSIS AND HAEMOSTASIS 2022; 6:e26-e32. [PMID: 35088024 PMCID: PMC8786557 DOI: 10.1055/a-1719-6178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/10/2021] [Indexed: 11/05/2022]
Abstract
Objective Although blood thrombogenicity seems to be one of the determinant factors for the development of acute myocardial infarction (MI), it has not been dealt with in-depth. This study aimed to investigate blood thrombogenicity and its change in acute MI patients. Methods and Results We designed a prospective, observational study that included 51 acute MI patients and 83 stable coronary artery disease (CAD) patients who underwent cardiac catheterization, comparing thrombogenicity of the whole blood between: (1) acute MI patients and stable CAD patients; and (2) acute and chronic phase in MI patients. Blood thrombogenicity was evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC 30 ) for the AR-chip. Acute MI patients had significantly higher AUC 30 than stable CAD patients (median [interquartile range], 1,771 [1,585-1,884] vs. 1,677 [1,527-1,756], p = 0.010). Multivariate regression analysis identified acute MI with initial TIMI flow grade 0/1 as an independent determinant of high AUC 30 ( β = 0.211, p = 0.013). In acute MI patients, AUC 30 decreased significantly from acute to chronic phase (1,859 [1,550-2,008] to 1,521 [1,328-1,745], p = 0.001). Conclusion Blood thrombogenicity was significantly higher in acute MI patients than in stable CAD patients. Acute MI with initial TIMI flow grade 0/1 was significantly associated with high blood thrombogenicity by multivariate analysis. In acute MI patients, blood thrombogenicity was temporarily higher in acute phase than in chronic phase.
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Affiliation(s)
- Shumpei Kosugi
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yasunori Ueda
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan,Address for correspondence Yasunori Ueda, MD, PhD, FACC, FESC, FJCC, FJCA Cardiovascular Division, National Hospital Organization Osaka National Hospital2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006Japan
| | - Haruhiko Abe
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kuniyasu Ikeoka
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Tsuyoshi Mishima
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Tatsuhisa Ozaki
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kohtaro Takayasu
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takuya Ohashi
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Haruya Yamane
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masayuki Nakamura
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takashi Fukushima
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kohei Horiuchi
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takashi Iehara
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Satoshi Osaki
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Kazuki Ozato
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Koichi Inoue
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yukihiro Koretsune
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Yasushi Matsumura
- Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan
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Zhao X, Niu Q, Gan L, Hou FF, Liang X, Ni Z, Chen X, Chen Y, McCullough K, Robinson B, Zuo L. Thrombocytopenia predicts mortality in Chinese hemodialysis patients- an analysis of the China DOPPS. BMC Nephrol 2022; 23:11. [PMID: 34979949 PMCID: PMC8722075 DOI: 10.1186/s12882-021-02579-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/22/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Hemodialysis (HD) patients have a higher mortality rate compared with general population. Our previous study revealed that platelet counts might be a potential risk factor. The role of platelets in HD patients has rarely been studied. The aim of this study is to examine if there is an association of thrombocytopenia (TP) with elevated risk of all-cause mortality and cardiovascular (CV) death in Chinese HD patients. METHODS Data from a prospective cohort study, China Dialysis Outcomes and Practice Patterns Study (DOPPS) 5, were analyzed. Demographic data, comorbidities, platelet counts and other lab data, and death records which extracted from the medical record were analyzed. TP was defined as the platelet count below the lower normal limit (< 100*109/L). Associations between platelet counts and all-cause and CV mortality were evaluated using Cox regression models. Stepwise multivariate logistic regression was used to identify the independent associated factors, and subgroup analyses were also carried out. RESULTS Of 1369 patients, 11.2% (154) had TP at enrollment. The all-cause mortality rates were 26.0% vs. 13.3% (p < 0.001) in patients with and without TP. TP was associated with higher all-cause mortality after adjusted for covariates (HR:1.73,95%CI:1.11,2.71), but was not associated with CV death after fully adjusted (HR:1.71,95%CI:0.88,3.33). Multivariate logistic regression showed that urine output < 200 ml/day, cerebrovascular disease, hepatitis (B or C), and white blood cells were independent impact factors (P < 0.05). Subgroup analysis found that the effect of TP on all-cause mortality was more prominent in patients with diabetes or hypertension, who on dialysis thrice a week, with lower ALB (< 4 g/dl) or higher hemoglobin, and patients without congestive heart failure, cerebrovascular disease, or hepatitis (P < 0.05). CONCLUSION In Chinese HD patients, TP is associated with higher risk of all-cause mortality, but not cardiovascular mortality. Platelet counts may be a useful prognostic marker for clinical outcomes among HD patients, though additional study is needed.
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Affiliation(s)
- Xinju Zhao
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Qingyu Niu
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China
| | - Fan Fan Hou
- Division of Nephrology, Nanfang Hospital, Southern Medical University, National Clinical Research Center of Kidney Disease, State Key Laboratory of Organ Failure Research, 1838 North Guangzhou Avenue, Guangzhou, China
| | - Xinling Liang
- Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhaohui Ni
- Department of Nephrology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiaonong Chen
- Division of Nephrology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yuqing Chen
- Renal Division, Peking University First Hospital, Beijing, China
| | | | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, MI, USA
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Unit 10C in Ward Building; 11 Xizhimennan Street, Xicheng District, Beijing, 100044, China.
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Platelet-lymphocyte ratio as a new predictor of in-hospital mortality in cardiac intensive care unit patients. Sci Rep 2021; 11:23578. [PMID: 34880259 PMCID: PMC8654817 DOI: 10.1038/s41598-021-02686-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022] Open
Abstract
It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases. As a combination of platelet and lymphocyte, platelet-lymphocyte ratio (PLR) was proved to be correlated with the severity as well as prognosis of cardiovascular diseases. Exploring the relationship between PLR and in-hospital mortality in cardiac intensive care unit (CICU) patients was the purpose of this study. PLR was calculated by dividing platelet count by lymphocyte count. All patients were grouped by PLR quartiles and the primary outcome was in-hospital mortality. The independent effect of PLR was determined by binary logistic regression analysis. The curve in line with overall trend was drawn by local weighted regression (Lowess). Subgroup analysis was used to determine the relationship between PLR and in-hospital mortality in different subgroups. We included 5577 CICU patients. As PLR quartiles increased, in-hospital mortality increased significantly (Quartile 4 vs. Quartile 1: 13.9 vs. 8.3, P < 0.001). After adjusting for confounding variables, PLR was proved to be independently associated with increased risk of in-hospital mortality (Quartile 4 vs. Quartile 1: OR 95% CI 1.55, 1.08–2.21, P = 0.016, P for trend < 0.001). The Lowess curves showed a positive relationship between PLR and in-hospital mortality. The subgroup analysis revealed that patients with low Acute Physiology and Chronic Health Evaluation IV (APACHE IV) or with less comorbidities had higher risk of mortality for PLR. Further, PLR quartiles had positive relation with length of CICU stay (Quartile 4 vs. Quartile 1: 2.7, 1.6–5.2 vs. 2.1, 1.3–3.9, P < 0.001), and the length of hospital stay (Quartile 4 vs. Quartile 1: 7.9, 4.6–13.1 vs. 5.8, 3.3–9.8, P < 0.001). PLR was independently associated with in-hospital mortality in CICU patients.
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Toyoda Y, Tateno K, Takeda Y, Kobayashi Y. Significance of mild thrombocytopenia in maintenance hemodialysis patients; a retrospective cohort study. Platelets 2021; 33:735-742. [PMID: 34672911 DOI: 10.1080/09537104.2021.1983531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Platelet activation in the hemodialysis (HD) circuit often causes thrombocytopenia. However, its clinical and pathophysiological significance has rarely been explored. Herein, we investigated the predictive value of thrombocytopenia for cardiovascular events (CVE) in maintenance HD patients and attempted to explore its mechanistic background considering recent knowledge of platelet dynamics. We conducted a retrospective cohort study on HD patients with the composite primary endpoint of predicting CVE, i.e., myocardial infarction, ischemic stroke, and cardiovascular death. Baseline clinical data were analyzed and explored. Multivariate Cox regression analysis showed that platelet decrease was independently associated with CVE. Thrombocytopenia was correlated with the disuse of antiplatelet therapy (APT) and macrocytosis. These findings are possibly associated with platelet activation and senescent hematopoiesis. The prognostic significance of thrombocytopenia was more prominent in patients undergoing APT, implying the presence of APT-resistant platelets in such patients. To fully explain these results, we hypothesized that HD-activated platelets induce the biological aging of hematopoiesis, which is presumably extramedullary in the lung, where activated platelets could deliver massive amounts of inflammatory cytokines and reactive oxidative species. This results in the production of qualitatively altered and hyper-reactive platelets, a process that could form a vicious cycle that induces CVE-associated thrombocytopenia. Further investigations focusing on the dynamics of the biological aging of platelets in HD patients are warranted.
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Affiliation(s)
- Yukiko Toyoda
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kaoru Tateno
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.,Department of Hemodialysis, Yamanouchi Hospital, Mobara, Japan.,Department of Cardiology, International University of Health and Welfare Narita Hospital, Narita, Japan
| | - Yorinobu Takeda
- Department of Hemodialysis, Yamanouchi Hospital, Mobara, Japan
| | - Yoshio Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan
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Falk RS, Mariampillai JE, Prestgaard EE, Heir T, Bodegård J, Robsahm TE, Grundvold I, Skretteberg PT, Engeseth K, Bjornholt JV, Stavem K, Liestøl K, Sandvik L, Thaulow E, Erikssen G, Kjeldsen SE, Gjesdal K, Erikssen JE. The Oslo Ischaemia Study: cohort profile. BMJ Open 2021; 11:e049111. [PMID: 34645662 PMCID: PMC8515426 DOI: 10.1136/bmjopen-2021-049111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE The Oslo Ischaemia Study was designed to investigate the prevalence and predictors of silent coronary disease in Norwegian middle-aged men, specifically validating exercise electrocardiography (ECG) findings compared with angiography. The study has been important in investigating long-term predictors of cardiovascular morbidity and mortality, as well as investigating a broad spectrum of epidemiological and public health perspectives. PARTICIPANTS In 1972-1975, 2014 healthy men, 40-59 years old, were enrolled in the study. Comprehensive clinical examination included an ECG-monitored exercise test at baseline and follow-ups. The cohort has been re-examined four times during 20 years. Linkage to health records and national health registries has ensured complete endpoint registration of morbidity until the end of 2006, and cancer and mortality until the end of 2017. FINDINGS TO DATE The early study results provided new evidence, as many participants with a positive exercise ECG, but no chest pain ('silent ischaemia'), did not have significant coronary artery stenosis after all. Still, they were over-represented with coronary disease after years of follow-up. Furthermore, participants with the highest physical fitness had lower risk of cardiovascular disease, and the magnitude of blood pressure responses to moderate exercise was shown to influence the risk of cardiovascular disease and mortality. With time, follow-up data allowed the scope of research to expand into other fields of medicine, with the aim of investigating predictors and the importance of lifestyle and risk factors. FUTURE PLANS Recently, the Oslo Ischaemia Study has been found worthy, as the first scientific study, to be preserved by The National Archives of Norway. All the study material will be digitised, free to use and accessible for all. In 2030, the Oslo Ischaemia Study will be linked to the Norwegian Cause of Death Registry to obtain complete follow-up to death. Thus, a broad spectrum of additional opportunities opens.
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Affiliation(s)
- Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | | | | | - Trond Heir
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Bodegård
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | | | - Irene Grundvold
- Department of Cardiology, Akershus University Hospital, Lorenskog, Lørenskog, Norway
| | | | - Kristian Engeseth
- Department of Cardiology, Akershus University Hospital, Lorenskog, Lørenskog, Norway
| | - Jorgen Vildershoj Bjornholt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Microbiology, Oslo University Hospital, Oslo, Norway
| | - Knut Stavem
- Department of Pulmonary Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Lørenskog, Norway
| | - Knut Liestøl
- Institute of Informatics, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Erik Thaulow
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Paediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Gunnar Erikssen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Sverre E Kjeldsen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Nephrology, Oslo University Hospital, Oslo, Norway
| | - Knut Gjesdal
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Jan E Erikssen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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30
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Mikaelsdottir E, Thorleifsson G, Stefansdottir L, Halldorsson G, Sigurdsson JK, Lund SH, Tragante V, Melsted P, Rognvaldsson S, Norland K, Helgadottir A, Magnusson MK, Ragnarsson GB, Kristinsson SY, Reykdal S, Vidarsson B, Gudmundsdottir IJ, Olafsson I, Onundarson PT, Sigurdardottir O, Sigurdsson EL, Grondal G, Geirsson AJ, Geirsson G, Gudmundsson J, Holm H, Saevarsdottir S, Jonsdottir I, Thorgeirsson G, Gudbjartsson DF, Thorsteinsdottir U, Rafnar T, Stefansson K. Genetic variants associated with platelet count are predictive of human disease and physiological markers. Commun Biol 2021; 4:1132. [PMID: 34580418 PMCID: PMC8476563 DOI: 10.1038/s42003-021-02642-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 09/07/2021] [Indexed: 12/13/2022] Open
Abstract
Platelets play an important role in hemostasis and other aspects of vascular biology. We conducted a meta-analysis of platelet count GWAS using data on 536,974 Europeans and identified 577 independent associations. To search for mechanisms through which these variants affect platelets, we applied cis-expression quantitative trait locus, DEPICT and IPA analyses and assessed genetic sharing between platelet count and various traits using polygenic risk scoring. We found genetic sharing between platelet count and counts of other blood cells (except red blood cells), in addition to several other quantitative traits, including markers of cardiovascular, liver and kidney functions, height, and weight. Platelet count polygenic risk score was predictive of myeloproliferative neoplasms, rheumatoid arthritis, ankylosing spondylitis, hypertension, and benign prostate hyperplasia. Taken together, these results advance understanding of diverse aspects of platelet biology and how they affect biological processes in health and disease. Evgenia Mikaelsdottir et al. report a study of variants associated with platelet count among European individuals where they identify 577 associations. They also report a genetic overlap between platelet count and human diseases, including myeloproliferative neoplasms, rheumatoid arthritis, and hypertension, as well as a genetic overlap between platelet count and various physiological markers.
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Affiliation(s)
| | | | | | | | | | - Sigrun H Lund
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland
| | | | - Pall Melsted
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | | | | | | | - Magnus K Magnusson
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland
| | - Gunnar B Ragnarsson
- Department of Oncology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Sigurdur Y Kristinsson
- Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,Department of Hematology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Sigrun Reykdal
- Department of Hematology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Brynjar Vidarsson
- Department of Hematology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | | | - Isleifur Olafsson
- Department of Clinical Biochemistry, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Pall T Onundarson
- Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,Laboratory Hematology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Olof Sigurdardottir
- Department of Clinical Biochemistry, Akureyri Hospital, 600, Akureyri, Iceland
| | | | - Gerdur Grondal
- Department of Rheumatology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Arni J Geirsson
- Department of Rheumatology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Gudmundur Geirsson
- Department of Urology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | | | - Hilma Holm
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland
| | - Saedis Saevarsdottir
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.,Department of Rheumatology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Ingileif Jonsdottir
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland
| | - Gudmundur Thorgeirsson
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,Department of Cardiology, Landspitali-University Hospital, 101, Reykjavik, Iceland
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Unnur Thorsteinsdottir
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland.,Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland
| | - Thorunn Rafnar
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland
| | - Kari Stefansson
- deCODE Genetics/Amgen, Sturlugata 8, 101, Reykjavik, Iceland. .,Faculty of Medicine, University of Iceland, 101, Reykjavik, Iceland.
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31
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Patti G, Lio V, Di Martino G, Ricci F, Renda G, Melander O, Engström G, Hamrefors V, De Caterina R, Fedorowski A. Clustering of blood cell count abnormalities and future risk of death. Eur J Clin Invest 2021; 51:e13562. [PMID: 33960412 PMCID: PMC8365677 DOI: 10.1111/eci.13562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/08/2021] [Accepted: 03/24/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The identification of novel predictors of poor outcome may help stratify cardiovascular risk. Aim was to evaluate the individual contribution of blood cell count parameters, as well as their clustering, on the risk of death and cardiovascular events over the long term in the population-based Malmö Diet and Cancer Study cohort. METHODS In 30,447 individuals (age 57 ± 8 years), we assessed the incidence of all-cause death (primary endpoint) and major adverse cardiovascular events (MACE, secondary outcome measure) according to absence or presence of one, two and three factors at baseline out of the following: anaemia, leukocytosis and thrombocytosis. Median follow-up was 16 years. RESULTS The percentages of all-cause death were 19.5% in individuals without factors, 21.3% in those with one factor, 27.4% with two and 46.4% with three (log-rank test P < .001). The crude incidence of MACE was 28.0%, 29.2%, 35.5% and 57.1%, respectively (log-rank test P < .001). At multivariate analysis, we found a stepwise increase in overall mortality with increasing number of prevalent factors (one factor: HR 1.23, 95% CI 1.14-1.31, P < .001; two factors: 1.61, 1.37-1.89, P < .001; three factors: 2.69, 1.44-5.01, P = .002, vs no factor). Similar findings were observed for the incidence of MACE (one factor: adjusted HR 1.18, 95% CI 1.11-1.24, P < .001; two factors: 1.52, 1.33-1.76, P < .001; three factors: 2.03, 1.21-3.67, P < .001, vs no factor). CONCLUSIONS The easily assessable clustering of anaemia, leukocytosis and thrombocytosis heralds higher incidence of death and adverse cardiovascular events.
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Affiliation(s)
- Giuseppe Patti
- Chair of Cardiology, University of Eastern Piedmont and Maggiore della Carità Hospital, Novara, Italy
| | - Veronica Lio
- Chair of Cardiology, University of Eastern Piedmont and Maggiore della Carità Hospital, Novara, Italy
| | - Giuseppe Di Martino
- Department of Medicine and Ageing Sciences, "G. d'Annunzio" University, Chieti, Italy
| | - Fabrizio Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, G. d'Annunzio University, Chieti, Italy
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | - Raffaele De Caterina
- University Cardiology Division, University of Pisa, Pisa University Hospital, Pisa, Italy
| | - Artur Fedorowski
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Cardiology, Skåne University Hospital, Malmö, Sweden
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32
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Barale C, Melchionda E, Morotti A, Russo I. PCSK9 Biology and Its Role in Atherothrombosis. Int J Mol Sci 2021; 22:ijms22115880. [PMID: 34070931 PMCID: PMC8198903 DOI: 10.3390/ijms22115880] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 12/11/2022] Open
Abstract
It is now about 20 years since the first case of a gain-of-function mutation involving the as-yet-unknown actor in cholesterol homeostasis, proprotein convertase subtilisin/kexin type 9 (PCSK9), was described. It was soon clear that this protein would have been of huge scientific and clinical value as a therapeutic strategy for dyslipidemia and atherosclerosis-associated cardiovascular disease (CVD) management. Indeed, PCSK9 is a serine protease belonging to the proprotein convertase family, mainly produced by the liver, and essential for metabolism of LDL particles by inhibiting LDL receptor (LDLR) recirculation to the cell surface with the consequent upregulation of LDLR-dependent LDL-C levels. Beyond its effects on LDL metabolism, several studies revealed the existence of additional roles of PCSK9 in different stages of atherosclerosis, also for its ability to target other members of the LDLR family. PCSK9 from plasma and vascular cells can contribute to the development of atherosclerotic plaque and thrombosis by promoting platelet activation, leukocyte recruitment and clot formation, also through mechanisms not related to systemic lipid changes. These results further supported the value for the potential cardiovascular benefits of therapies based on PCSK9 inhibition. Actually, the passive immunization with anti-PCSK9 antibodies, evolocumab and alirocumab, is shown to be effective in dramatically reducing the LDL-C levels and attenuating CVD. While monoclonal antibodies sequester circulating PCSK9, inclisiran, a small interfering RNA, is a new drug that inhibits PCSK9 synthesis with the important advantage, compared with PCSK9 mAbs, to preserve its pharmacodynamic effects when administrated every 6 months. Here, we will focus on the major understandings related to PCSK9, from its discovery to its role in lipoprotein metabolism, involvement in atherothrombosis and a brief excursus on approved current therapies used to inhibit its action.
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MESH Headings
- Antibodies, Monoclonal, Humanized/therapeutic use
- Atherosclerosis/drug therapy
- Atherosclerosis/enzymology
- Atherosclerosis/genetics
- Atherosclerosis/pathology
- Blood Platelets/drug effects
- Blood Platelets/enzymology
- Blood Platelets/pathology
- Cholesterol, LDL/antagonists & inhibitors
- Cholesterol, LDL/metabolism
- Dyslipidemias/drug therapy
- Dyslipidemias/enzymology
- Dyslipidemias/genetics
- Dyslipidemias/pathology
- Fibrinolytic Agents/therapeutic use
- Gene Expression Regulation
- Humans
- Hypolipidemic Agents/therapeutic use
- Lipid Metabolism/drug effects
- Lipid Metabolism/genetics
- PCSK9 Inhibitors
- Plaque, Atherosclerotic/drug therapy
- Plaque, Atherosclerotic/enzymology
- Plaque, Atherosclerotic/genetics
- Plaque, Atherosclerotic/pathology
- Platelet Activation/drug effects
- Proprotein Convertase 9/biosynthesis
- Proprotein Convertase 9/genetics
- RNA, Small Interfering/therapeutic use
- Receptors, LDL/genetics
- Receptors, LDL/metabolism
- Signal Transduction
- Thrombosis/enzymology
- Thrombosis/genetics
- Thrombosis/pathology
- Thrombosis/prevention & control
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33
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Infeld M, Friede KA, San TR, Knickerbocker HJ, Ginsburg GS, Ortel TL, Voora D. Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans. J Thromb Thrombolysis 2021; 51:249-259. [PMID: 33159252 PMCID: PMC7889728 DOI: 10.1007/s11239-020-02327-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 12/19/2022]
Abstract
Platelet gene polymorphisms are associated with variable on-treatment platelet reactivity and vary by race. Whether differences in platelet reactivity and aspirin or ticagrelor exist between African-American and European-Americans remains poorly understood. Biological samples from three prior prospective antiplatelet challenge studies at the Duke Clinical Research Unit were used to compare platelet reactivity between African-American and European-American subjects. Platelet reactivity at baseline, on-aspirin, on-ticagrelor, and the treatment effect of aspirin or ticagrelor were compared between groups using an adjusted mixed effects model. Compared with European-Americans (n = 282; 50% female; mean ± standard deviation age, 50 ± 16), African-Americans (n = 209; 67% female; age 48 ± 12) had lower baseline platelet reactivity with platelet function analyzer-100 (PFA-100) (p < 0.01) and with light transmission aggregometry (LTA) in response to arachidonic acid (AA), adenosine diphosphate (ADP), and epinephrine agonists (p < 0.05). African-Americans had lower platelet reactivity on aspirin in response to ADP, epinephrine, and collagen (p < 0.05) and on ticagrelor in response to AA, ADP, and collagen (p < 0.05). The treatment effect of aspirin was greater in European-Americans with an AA agonist (p = 0.002). Between-race differences with in vitro aspirin mirrored those seen in vivo. The treatment effect of ticagrelor was greater in European-Americans in response to ADP (p < 0.05) but with collagen, the treatment effect was greater for African-Americans (p < 0.05). Platelet reactivity was overall lower in African-Americans off-treatment, on aspirin, and on ticagrelor. European-Americans experienced greater platelet suppression on aspirin and on ticagrelor. The aspirin response difference in vivo and in vitro suggests a mechanism intrinsic to the platelet. Whether the absolute level of platelet reactivity or the degree of platelet suppression after treatment is more important for clinical outcomes is uncertain.
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Affiliation(s)
- Margaret Infeld
- Division of Cardiology, Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, USA
| | - Kevin A Friede
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA
| | - Tan Ru San
- Department of Cardiology, National Heart Centre, Singapore, Singapore
| | - Holly J Knickerbocker
- Center for Applied Genomics & Precision Medicine, Duke University, 2187 CIEMAS, Campus Box 3382, Durham, NC, 27708, USA
| | - Geoffrey S Ginsburg
- Center for Applied Genomics & Precision Medicine, Duke University, 2187 CIEMAS, Campus Box 3382, Durham, NC, 27708, USA
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA
| | - Thomas L Ortel
- Division of Hematology, Duke University, Durham, NC, USA
| | - Deepak Voora
- Center for Applied Genomics & Precision Medicine, Duke University, 2187 CIEMAS, Campus Box 3382, Durham, NC, 27708, USA.
- Division of Cardiology, Department of Medicine, Duke University, Durham, NC, USA.
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Atzeni F, Nucera V, Gerratana E, Fiorenza A, Gianturco L, Corda M, Sarzi-Puttini P. Cardiovascular Consequences of Autoimmune Rheumatic Diseases. Curr Vasc Pharmacol 2020; 18:566-579. [PMID: 31985379 DOI: 10.2174/1570161118666200127142936] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/23/2019] [Accepted: 12/28/2019] [Indexed: 12/23/2022]
Abstract
The increased risk of cardiovascular disease (CVD) among patients with autoimmune rheumatic diseases such as rheumatoid arthritis, spondyloarthritis and systemic lupus erythematosus has been extensively documented. Sub-clinical atherosclerosis can be assessed using various non-invasive imaging techniques. However, the mechanisms underlying the higher risk of atherosclerotic CVD in patients with autoimmune rheumatic diseases are not fully known, although they seem to include chronic low-grade systemic inflammation leading to prolonged endothelial activation, accompanied by a pro-thrombotic/pro-coagulant and autoantibody state. Furthermore, sub-clinical atherosclerosis is also influenced by other traditional risk factors for CVD. Including the individual components of the metabolic syndrome (MetS: obesity, impaired glucose metabolism, dyslipidemia and high blood pressure), the degree of which is higher in these patients than in controls. The aim of this narrative review is to discuss the CV manifestations and risk factors involved in the increased risk of CVD among patients with autoimmune rheumatic diseases.
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Affiliation(s)
- Fabiola Atzeni
- Rheumatology Unit, University of Messina, Messina, Italy
| | - Valeria Nucera
- Rheumatology Unit, University of Messina, Messina, Italy
| | | | | | - Luigi Gianturco
- Cardiology Unit, Beato Matteo Hospital, GSD Hospitals, Vigevano, Pavia, Italy
| | - Marco Corda
- Cardiology Unit, Brotzu Hospital, Cagliari, Italy
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35
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Urabe S, Kokubo K, Tsukao H, Kobayashi K, Hirose M, Kobayashi H. Suppression of platelet reactivity during dialysis by addition of a nitric oxide donor to the dialysis fluid. RENAL REPLACEMENT THERAPY 2020. [DOI: 10.1186/s41100-020-00283-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Dialysis membranes that release nitric oxide (NO) from their surface, mimicking one of the functions of endothelial cells, may suppress platelet reactivity during hemodialysis treatment. The aim of the present study was to examine whether the addition of a NO donor to the dialysis fluid can suppress platelet reactivity during dialysis.
Methods
Porcine whole blood was circulated for 4 h through a polysulfone (PS) dialyzer or polymethylmethacrylate (PMMA) dialyzer. After the blood was circulated through the blood circuit and dialyzer, sodium nitroprusside was added to the dialysis fluid as a NO donor. The changes in the platelet reactivity, measured by the platelet aggregation activity by the addition of adenosine diphosphate or collagen in the blood sample, were evaluated during ex vivo dialysis experiments in the presence of a dialysis fluid containing or not containing a NO donor.
Results
The platelet aggregation activity was significantly decreased at 30 min after the start of the experiment in the case where nitroprusside was added to the dialysis fluid (the NO (+) condition) as compared to the case where no nitroprusside was added to the dialysis fluid (the NO (−) condition), for both the PS and PMMA membranes. The suppression of the platelet reactivity in the NO (+) condition was sustained until the end of the experimental period (240 min). The platelet cyclic guanosine monophosphate level was also significantly increased in the NO (+) condition as compared to the NO (−) condition.
Conclusions
NO in the dialysis fluid appears to be capable of suppressing the increase of the platelet reactivity observed during dialysis.
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36
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Samuel D, Bhat AN, Prabhu VM. Platelet Indices as Predictive Markers of Prognosis in Critically Ill Patients: A Prospective Study. Indian J Crit Care Med 2020; 24:817-822. [PMID: 33132566 PMCID: PMC7584825 DOI: 10.5005/jp-journals-10071-23574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Platelets (PLTs) are dynamic blood molecules which perform multiple physiological functions. Platelet derangements are commonly encountered in intensive care units (ICUs). The relationship of PLT indices with all-cause mortality, acute physiology and chronic health evaluation IV (APACHE IV), diabetes mellitus (DM), and length of stay in ICU is debatable and hence this study was undertaken to bridge this gap of knowledge. Materials and methods Prospective data were collected for 20 months in the ICU of our hospital. Platelet indices were analyzed among survivors and non-survivors. Acute physiology and chronic health evaluation IV scores were used to study the relationship between PLT indices and illness severity. Receiver operating characteristic curves were constructed to compare the performances of PLT indices in predicting mortality, while the effect of DM on PLT indices was evaluated using regression analysis. Results A total of 170 out of 345 patients (119 survivors, 51 non-survivors) met the study criteria. Patients with decreased PLT count and plateletcrit (PCT) (p < 0.001 and 0.001, respectively), increased mean platelet volume (MPV) and platelet distribution width (PDW) (p = 0.014 and 0.004, respectively) had a significant correlation with increased risk of mortality than those with normal PLT indices. These patients also had a higher APACHE IV and acute physiology score (p < 0.001). No significant relationship was found between the PLT indices and the length of ICU stay. The influence of each PLT index adjusted to DM was significant in univariate regression analysis, whereas in multivariate only PDW had a significant influence. Conclusion Patients with low PLT, PCT and high MPV, PDW were associated with more severe illness, poor prognosis, and a higher risk of mortality. Platelet distribution width is the preferred PLT index in a diabetic patient to predict clinical status. Clinical significance Platelet indices which are routinely available can be effectively used as a morbidity and mortality indicator in critically ill patients. How to cite this article Samuel D, Bhat AN, Prabhu VM. Platelet Indices as Predictive Markers of Prognosis in Critically Ill Patients: A Prospective Study. Indian J Crit Care Med 2020;24(9):817–822.
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Affiliation(s)
- Deepthi Samuel
- Department of General Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ajay Nagesh Bhat
- Department of General Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Venkatraya M Prabhu
- Department of General Medicine, Kasturba Medical College, Mangaluru, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Madeo F, Hofer SJ, Pendl T, Bauer MA, Eisenberg T, Carmona-Gutierrez D, Kroemer G. Nutritional Aspects of Spermidine. Annu Rev Nutr 2020; 40:135-159. [DOI: 10.1146/annurev-nutr-120419-015419] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Natural polyamines (spermidine and spermine) are small, positively charged molecules that are ubiquitously found within organisms and cells. They exert numerous (intra)cellular functions and have been implicated to protect against several age-related diseases. Although polyamine levels decline in a complex age-dependent, tissue-, and cell type–specific manner, they are maintained in healthy nonagenarians and centenarians. Increased polyamine levels, including through enhanced dietary intake, have been consistently linked to improved health and reduced overall mortality. In preclinical models, dietary supplementation with spermidine prolongs life span and health span. In this review, we highlight salient aspects of nutritional polyamine intake and summarize the current knowledge of organismal and cellular uptake and distribution of dietary (and gastrointestinal) polyamines and their impact on human health. We further summarize clinical and epidemiological studies of dietary polyamines.
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Affiliation(s)
- Frank Madeo
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, 8010 Graz, Austria
- BioTechMed-Graz, 8010 Graz, Austria
- Field of Excellence BioHealth, University of Graz, 8010 Graz, Austria
| | - Sebastian J. Hofer
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, 8010 Graz, Austria
| | - Tobias Pendl
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, 8010 Graz, Austria
| | - Maria A. Bauer
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, 8010 Graz, Austria
| | - Tobias Eisenberg
- Institute of Molecular Biosciences, NAWI Graz, University of Graz, 8010 Graz, Austria
- BioTechMed-Graz, 8010 Graz, Austria
- Field of Excellence BioHealth, University of Graz, 8010 Graz, Austria
- Central Lab Graz Cell Informatics and Analyses (GRACIA), NAWI Graz, University of Graz, 8010 Graz, Austria
| | | | - Guido Kroemer
- Equipe Labellisée par la Ligue Contre le Cancer, Université de Paris, Sorbonne Université, INSERM U1138, Centre de Recherche des Cordeliers, 75006 Paris, France
- Metabolomics and Cell Biology Platforms, Institut Gustave Roussy, F-94805 Villejuif, France
- Pôle de Biologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, F-75015 Paris, France
- Suzhou Institute for Systems Medicine, Chinese Academy of Medical Sciences, Jiangsu 215163, Suzhou, China
- Department of Women's and Children's Health, Karolinska Institute, Karolinska University, S-17177 Solna, Sweden
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Barrett TJ, Schlegel M, Zhou F, Gorenchtein M, Bolstorff J, Moore KJ, Fisher EA, Berger JS. Platelet regulation of myeloid suppressor of cytokine signaling 3 accelerates atherosclerosis. Sci Transl Med 2020; 11:11/517/eaax0481. [PMID: 31694925 DOI: 10.1126/scitranslmed.aax0481] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/19/2019] [Accepted: 10/04/2019] [Indexed: 12/19/2022]
Abstract
Platelets are best known as mediators of hemostasis and thrombosis; however, their inflammatory effector properties are increasingly recognized. Atherosclerosis, a chronic vascular inflammatory disease, represents the interplay between lipid deposition in the artery wall and unresolved inflammation. Here, we reveal that platelets induce monocyte migration and recruitment into atherosclerotic plaques, resulting in plaque platelet-macrophage aggregates. In Ldlr -/- mice fed a Western diet, platelet depletion decreased plaque size and necrotic area and attenuated macrophage accumulation. Platelets drive atherogenesis by skewing plaque macrophages to an inflammatory phenotype, increasing myeloid suppressor of cytokine signaling 3 (SOCS3) expression and reducing the Socs1:Socs3 ratio. Platelet-induced Socs3 expression regulates plaque macrophage reprogramming by promoting inflammatory cytokine production (Il6, Il1b, and Tnfa) and impairing phagocytic capacity, dysfunctions that contribute to unresolved inflammation and sustained plaque growth. Translating our data to humans with cardiovascular disease, we found that women with, versus without, myocardial infarction have up-regulation of SOCS3, lower SOCS1:SOCS3, and increased monocyte-platelet aggregate. A second cohort of patients with lower extremity atherosclerosis demonstrated that SOCS3 and the SOCS1:SOCS3 ratio correlated with platelet activity and inflammation. Collectively, these data provide a causative link between platelet-mediated myeloid inflammation and dysfunction, SOCS3, and cardiovascular disease. Our findings define an atherogenic role of platelets and highlight how, in the absence of thrombosis, platelets contribute to inflammation.
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Affiliation(s)
- Tessa J Barrett
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Martin Schlegel
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Felix Zhou
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Mike Gorenchtein
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Jennifer Bolstorff
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Kathryn J Moore
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Edward A Fisher
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA
| | - Jeffrey S Berger
- Marc and Ruti Bell Program in Vascular Biology, Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
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Badran HM, Fatah AA, Soltan G. Platelet/lymphocyte ratio for prediction of no-reflow phenomenon in ST-elevation myocardial infarction managed with primary percutaneous coronary intervention. J Clin Transl Res 2020; 6:20-26. [PMID: 32935070 PMCID: PMC7486979 DOI: 10.18053/jctres.06.202001.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/07/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022] Open
Abstract
Background Coronary no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI) is associated with a poor clinical outcome. Although its pathophysiology is not fully understood, a deregulated systemic inflammatory response plays an important role. We aimed to explore the relationship between platelet\lymphocyte ratio (PLR) and no-reflow in patients with acute STEMI who were treated with a primary percutaneous coronary intervention (PPCI). Methods A total of 200 patients with STEMI undergoing PPCI were included in the study. Transthoracic echocardiographic examination was performed to assess left ventricular (LV) ejection fraction (EF) and wall motion score index. Blood samples were assayed for platelet and lymphocyte count before PPCI. No-reflow was defined as coronary blood flow thrombolysis in myocardial infarction grade ≤II. Results No-reflow was observed in 58 (29%) of STEMI patients following PPCI. PLR was significantly higher in hypertensive patients compared to normotensive patients (144.7±91.6 vs. 109.1±47.1, respectively, P<0.001) and in the no-reflow group compared to the normal reflow group (214±93 vs. 101.6±51.3, respectively, P<0.0001). Logistic regression analysis revealed that PLR (β: 0.485, 95% CI: -0.006-0.001, P<0.002) and LV EF (β: 0.272, 95% CI: 0.009-0.034, P<0.001) were independent predictors of no-reflow after PPCI. Conclusion Pre-procedural increase in PLR is predictive of the no-reflow phenomenon following PPCI in STEMI patients. Relevance for Patients No reflow phenomenon is an unfavorable complication following PPCI in patients with acute STEMI. High pre-procedural PLR is an independent predictor of reperfusion failure and helps to identify patients who require prophylactic treatment.
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Affiliation(s)
| | | | - Ghada Soltan
- Department of Cardiology, Menoufia University, Egypt
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Dubinski D, Won SY, Behmanesh B, Brawanski N, Seifert V, Senft C, Konczalla J. Reactive Thrombocytosis in Non-aneurysmal Subarachnoid Hemorrhage. J Neurol Surg A Cent Eur Neurosurg 2020; 81:412-417. [PMID: 32438417 DOI: 10.1055/s-0040-1709167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The role of reactive thrombocytosis in non-aneurysmal subarachnoid hemorrhage (NA-SAH) is largely unexplored to date. Therefore, the impact of a quantitative thrombocyte dynamic in patients with NA-SAH and its clinical relevance were analyzed in the present study. METHODS In this retrospective analysis, 113 patients with nontraumatic and NA-SAH treated between 2003 and 2015 at our institution were included. World Federation of Neurosurgical Societies admission status, cerebral vasospasm, delayed infarction, hydrocephalus, need for ventriculoperitoneal (VP) shunt, and Fisher grade were analyzed for their association with reactive thrombocytosis. RESULTS Reactive thrombocytosis was not associated with hydrocephalus (p ≥ 0.05), need for VP shunt implantation (p ≥ 0.05), cerebral vasospasm (p ≥ 0.05), or delayed cerebral ischemia (p ≥ 0.05). CONCLUSION Our study is the first to investigate the role of thrombocyte dynamics, reactive thrombocytosis, and the clinical course of NA-SAH patients. Our analysis showed no significant impact of thrombocyte count on NA-SAH sequelae.
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Affiliation(s)
- Daniel Dubinski
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Sae-Yeon Won
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Bedjan Behmanesh
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Nina Brawanski
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Volker Seifert
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Christian Senft
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
| | - Juergen Konczalla
- Department of Neurosurgery, Goethe University Hospital, Frankfurt, Germany
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Warny M, Helby J, Birgens HS, Bojesen SE, Nordestgaard BG. Arterial and venous thrombosis by high platelet count and high hematocrit: 108 521 individuals from the Copenhagen General Population Study. J Thromb Haemost 2019; 17:1898-1911. [PMID: 31309714 DOI: 10.1111/jth.14574] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/11/2019] [Indexed: 08/31/2023]
Abstract
BACKGROUND It is unclear whether high platelet count or high hematocrit predict risk of thrombosis in individuals from the general population. OBJECTIVES We tested the hypothesis that individuals from the general population with high platelet count or high hematocrit have high risk of arterial and venous thrombosis. METHODS We prospectively followed 108 521 individuals from The Copenhagen General Population Study for a median of 8 years. Platelet count and blood hematocrit were measured at study entry. RESULTS AND CONCLUSION Multivariable adjusted hazard ratios for individuals with platelet counts in the top 5 percentiles (>398 × 109 /L) vs in the 25th-75th percentiles (231-316 × 109 /L) were 1.77 (95% confidence interval [CI], 1.38-2.24) for arterial thrombosis in the brain (38 and 26 events/10 000 person-years) and 0.82 (95%, 0.61-1.11) for arterial thrombosis in the heart (23 and 28 events/10 000 person-years). For individuals with hematocrit values in the top 5 percentiles (women/men: >45/>48%) vs the 25th-75th percentiles (women/men: 38.1-42/41.1-45%), hazard ratios were 1.27 (95% CI, 0.91-1.75) for arterial thrombosis in the brain (40 and 26 events/10 000 person-years) and 1.46 (95% CI, 1.06-2.00) for arterial thrombosis in the heart (43 and 25 events/10 000 person-years). Neither high platelet count nor high hematocrit was associated with risk of venous thromboembolism. When excluding individuals with myeloproliferative neoplasia from the main analyses, results on risk of thrombosis were similar. In this prospective study, high platelet counts were associated with 1.8-fold risk of arterial thrombosis in the brain, whereas high hematocrit was associated with 1.5-fold risk of arterial thrombosis in the heart.
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Affiliation(s)
- Marie Warny
- Department of Hematology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Jens Helby
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Internal Medicine, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Henrik S Birgens
- Department of Hematology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig E Bojesen
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Børge G Nordestgaard
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
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Abstract
Background Obesity is associated with chronic inflammation, liver steatosis and increased liver enzymes such as gamma-glutamyltransferase (GGT) and alanine aminotransferase (ALT), markers for non-alcoholic fatty liver disease (NAFLD) and liver fat content. Increased platelet counts (PCs) are a biomarker reflecting inflammation and the degree of fibrosis in NAFLD. We investigated alterations in PCs, GGT, ALT, C-reactive protein (CRP) and ferritin after Roux-en-Y gastric bypass (RYGBP). Methods One hundred twenty-four morbidly obese non-diabetic patients were evaluated before (baseline) and 12 months after (follow-up) RYGBP. Results Body mass index (BMI) was reduced from 43.5 kg/m2 (baseline) to 31.1 kg/m2 (follow-up), and p < 0.001 and weight declined from 126.2 to 89.0 kg. PCs decreased from 303 × 109 to 260 × 109/l, p < 0.001. GGT was reduced from 0.63 to 0.38 μkat/l, p < 0.001. ALT decreased from 0.69 to 0.59 μkat/l, p = 0.006. CRP was lowered from 7.3 to 5.4 mg/l p < 0.001 and ferritin from 106 to 84 μg/l p < 0.001. The alterations in PCs correlated with the changes in CRP (r = 0.38, p = 0.001), BMI (r = 0.25, p = 0.012), weight (r = 0.24, p = 0.015) and inversely correlated with ferritin (r = 21, p = 0.036). Conclusions PCs, GGT and ALT (markers for NAFLD), and CRP and ferritin (markers for inflammation) decreased in morbidly obese after RYGBP. The decrease in PCs correlated with alterations in CRP, BMI, weight and ferritin. The lowering of liver enzymes may reflect a lowered liver fat content and decreased general inflammation.
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High mean platelet volume to platelet count ratio as a predictor on poor outcomes after CABG. Gen Thorac Cardiovasc Surg 2019; 68:459-466. [PMID: 31515731 DOI: 10.1007/s11748-019-01202-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/04/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To determine the effect of mean platelet volume (MPV) to platelet count (PC) ratio on postoperative poor outcomes, early mortality and long-term survival rate in patients undergoing CABG. METHODS Between February 2016 and September 2018, all patients undergoing CABG in our department were retrospectively reviewed. A total of 213 consecutive patients were included in the study. RESULTS Mean age was 61.5 ± 9.7 years and mean follow-up of all patients was 1.4 ± 0.5 years. All patients were divided into two groups as high and low MPV/PC ratio in terms of 3.825 of cut-off point. 72 patients had a high MPV/PC ratio, whereas, 141 patients had low MPV/PC ratio. The rates of reoperation for early vein-graft occlusion, low cardiac output syndrome and respiratory complication were significantly higher in group 1 (p = 0.03, 0.04 and 0.01). The mean hospital length of stay was higher in group 1 (p = 0.03). MPV/PC ratio for reoperation for early vein-graft occlusion; MPV and ejection fraction for low cardiac output syndrome; hyperlipidemia, chronic renal failure history and MPV/PC ratio for sepsis; male gender, CRF history and CPB time for atrial fibrillation; age, congestive heart failure history, myocardial infarction history and CPB time for the early mortality were found to be independent predictors. Peripheral arterial diseases, USAP and MPV/PC ratio were found to be independent predictors for the late mortality. CONCLUSIONS A high MPV/PC ratio is associated with early vein-graft occlusion and poor postoperative outcomes in the early period after CABG. Furthermore, it has a negative effect on late survival.
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Lee HS, Koh IH, Kim HS, Kwon YJ. Platelet and white blood cell count are independently associated with sarcopenia: A nationwide population-based study. Thromb Res 2019; 183:36-44. [PMID: 31614293 DOI: 10.1016/j.thromres.2019.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/20/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Sarcopenia is attracting increasing attention due to its harmful impacts on health. Chronic inflammation is proposed to be a major cause of sarcopenia. Here, we aimed to identify whether white blood cell (WBC) and platelet count have independent roles in sarcopenia occurrence. METHOD AND MATERIALS This cross-sectional study analyzed 10,092 adults (4293 men and 5799 women) from the 2008-2011 Korea National Health and Nutrition Survey. Cut-off values for sarcopenia were defined as a skeletal muscle mass index <0.789 for men and <0.512 for women. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multiple logistic regression analysis after adjusting for confounding variables. ROC curve analysis was used to evaluate the ability of platelet count and white blood cell count to discriminate the presence of sarcopenia. RESULTS After adjusting for possible confounders, the OR (95% CI) for sarcopenia occurrence according to platelet counts was 1.62 (1.20-2.19) for the T3 group in men and 1.72 (1.28-2.31) for the T3 group in women, relative to the lowest platelet count tertile. After adjusting for same confounders, the ORs (95% CI) for sarcopenia occurrence according to WBC counts was 1.86 (1.35-2.57) for the T3 group in men, and 2.36 (1.77-3.13) for the T3 group in women, relative to the lowest WBC count tertile. We also found independent significant associations between platelet count, WBC count, and sarcopenia. CONCLUSIONS Higher platelet and WBC counts within the normal range are each independently associated with sarcopenia in Korean men and women. The inclusion of platelet, WBC, or combined platelet and WBC counts significantly improved the power to discriminate sarcopenia.
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Affiliation(s)
- Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Il-Hyun Koh
- Department of Orthopaedic Surgery, Yong-In Severance Hospital, Yonsei University College of Medicine, Gyeonggi, Republic of Korea.
| | - Hyoung-Sik Kim
- Department of Orthopaedic Surgery, Yong-In Severance Hospital, Yonsei University College of Medicine, Gyeonggi, Republic of Korea.
| | - Yu-Jin Kwon
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Family Medicine, Yong-In Severance Hospital, Yonsei University College of Medicine, Gyeonggi, Republic of Korea; Department of Medicine, Graduate School of Yonsei University College of Medicine, Seoul, Republic of Korea.
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Dose-dependent effects of fenugreek seed extract on the biochemical and haematological parameters in high-fat diet-fed rats. J Taibah Univ Med Sci 2019; 14:383-389. [PMID: 31488972 PMCID: PMC6717075 DOI: 10.1016/j.jtumed.2019.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 12/24/2022] Open
Abstract
Objective The present study was carried out to assess the effects of fenugreek seed extract on various biochemical and haematological parameters in high-fat diet (HFD)-fed rats. Methods Female Wistar rats were allocated into five groups (n = 6): 1) control rats, 2) HFD-fed control rats 3) rats fed with HFD and fenugreek (FG) seed extract at doses of 200 mg/kg/day, 300 mg/kg/day, and 400 mg/kg/day for 12 weeks. Blood was collected to examine the biochemical and haematological parameters using a veterinary blood cell counter; blood indices such as MCV, MCH, MCHC, red blood cell distribution width, haemoglobin (Hb) levels, haematocrit, and platelet counts were measured. Blood samples were centrifuged at 3000 rpm for 10 min at room temperature to obtain serum for the estimation of lipid profiles, and aspartate transaminase and alanine transaminase levels. Results Rats fed with FG at a dose of 400 mg/kg/day showed a significant increase in the red blood cell count, Hb levels, haematocrit, and MCV, and a significant decrease in the lymphocyte count. The total cholesterol, triglyceride, and low-density lipoprotein levels increased significantly (p < 0.05) in rats from the HFD control group, compared to those in the normal control group, but decreased significantly in rats fed with 400 mg/kg/day of FG. Conclusion The results of the current study suggest that FG seed extract exhibits hypolipidaemic activity and significantly improves the activity of hepatic enzymes, and the blood counts and indices in rats with HFD-induced obesity.
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Endothelial Function is improved by Inducing Microbial Polyamine Production in the Gut: A Randomized Placebo-Controlled Trial. Nutrients 2019; 11:nu11051188. [PMID: 31137855 PMCID: PMC6566626 DOI: 10.3390/nu11051188] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 12/20/2022] Open
Abstract
Recently, it was demonstrated that spermidine-induced autophagy reduces the risk of cardiovascular disease in mice. Intestinal bacteria are a major source of polyamines, including spermidine. We previously reported that the intake of both Bifidobacterium animalis subsp. lactis (Bifal) and arginine (Arg) increases the production of putrescine, a spermidine precursor, in the gut. Here, we investigated the effects of Bifal and Arg consumption on endothelial function in healthy subjects. Healthy individuals with body mass index (BMI) near the maximum value in the “healthy” range (BMI: 25) (n = 44) were provided normal yogurt containing Bifal and Arg (Bifal + Arg YG) or placebo (normal yogurt) for 12 weeks in this randomized, double-blinded, placebo-controlled, parallel-group comparative study. The reactive hyperemia index (RHI), the primary outcome, was measured using endo-peripheral arterial tone (EndoPAT). The change in RHI from week 0 to 12 in the Bifal + Arg YG group was significantly higher than that in the placebo group, indicating that Bifal + Arg YG intake improved endothelial function. At week 12, the concentrations of fecal putrescine and serum putrescine and spermidine in the Bifal + Arg YG group were significantly higher than those in the placebo group. This study suggests that consuming Bifal + Arg YG prevents or reduces the risk of atherosclerosis.
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Fawzy A, Anderson JA, Cowans NJ, Crim C, Wise R, Yates JC, Hansel NN. Association of platelet count with all-cause mortality and risk of cardiovascular and respiratory morbidity in stable COPD. Respir Res 2019; 20:86. [PMID: 31068182 PMCID: PMC6507019 DOI: 10.1186/s12931-019-1059-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/25/2019] [Indexed: 12/11/2022] Open
Abstract
Background Platelet count is a prognostic indicator in the general population and elderly. Thrombocytosis during acute exacerbation of COPD (AECOPD) has been associated with mortality; however, the relationship between platelet count and mortality in stable COPD is unknown. Methods We performed post hoc secondary analysis on a subsample of 1797 patients in the Study to Understand Mortality and Morbidity in COPD (SUMMIT) who had blood samples drawn at baseline. Participants were current or former smokers, 40–80 years old with moderate COPD and history or increased risk of cardiovascular (CV) disease. The primary outcome was on and post-treatment all-cause mortality. Secondary outcomes included first-on-treatment moderate/severe AECOPD and on-treatment CV composite event (CV death, myocardial infarction, stroke, unstable angina and transient ischemic attack). Multivariable Cox proportional hazards models were used to investigate study endpoint associations with platelet count quintile grouping, continuous platelet count utilizing two-term fractional polynomials, and categories of low, normal and high platelet count (< 150, ≥150 to < 300, ≥300 × 109/L). Results Patients were followed for 2.3 ± 0.9 years for vital status and 1.6 ± 1.1 years for morbidity endpoints during which 105 (5.8%) died, 651 (36.2%) experienced AECOPD (159 with severe AECOPD) and 86 (4.8%) experienced a CV event. A U-shaped association between platelet count and all-cause mortality was observed. Compared to the third quintile group (Q3) of platelet count, risk of death was increased in the lowest quintile group (Q1; hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 0.93–3.23) and highest quintile group (Q5; HR: 1.66; 95%CI: 0.89–3.10), though point estimates were imprecise. Using clinical cutoffs, compared with normal platelet counts (≥150 to < 300 × 109/L), risk of all-cause mortality was nominally increased among patients with thrombocytopenia (HR: 1.46; 95%CI: 0.81–2.64) and high platelet count (HR: 1.66; 95%CI: 0.96–2.86). Compared with Q3, CV events were nominally increased for Q5 (HR: 1.71; 95%CI: 0.83–3.49) and Q1 (HR: 1.41; 95%CI: 0.70, 2.85). There was no association between platelet count and AECOPD. Conclusions In stable COPD platelet count demonstrated a U-shaped association with increased risk of 3-year all-cause mortality, though a platelet count level above or below which risk of mortality was increased could not be definitively identified. Trial registration ClinicalTrials.gov NCT01313676.
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Affiliation(s)
- Ashraf Fawzy
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E. Monument St. 5th Floor, Baltimore, MD, USA
| | - Julie A Anderson
- Research & Development, GlaxoSmithKline plc, Stockley Park, Middlesex, UK
| | | | - Courtney Crim
- Research & Development, GlaxoSmithKline plc, Research Triangle Park, NC, USA
| | - Robert Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E. Monument St. 5th Floor, Baltimore, MD, USA
| | - Julie C Yates
- Research & Development, GlaxoSmithKline plc, Research Triangle Park, NC, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, 1830 E. Monument St. 5th Floor, Baltimore, MD, USA.
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Asghar S, Parvaiz F, Manzoor S. Multifaceted role of cancer educated platelets in survival of cancer cells. Thromb Res 2019; 177:42-50. [PMID: 30849514 DOI: 10.1016/j.thromres.2019.02.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/24/2019] [Accepted: 02/22/2019] [Indexed: 11/20/2022]
Abstract
Platelets, the derivatives of megakaryocytes, pose dynamic biological functions such as homeostasis and wound healing. The mechanisms involved in these processes are utilized by cancerous cells for proliferation and metastasis. Platelets through their activation establish an aggregate termed as Tumor cell induced platelet aggregation (TCIPA) that aids in establishing a niche for the primary tumor at secondary site while recruiting granulocytes and monocytes. The study of these close interactions between the tumor and the platelets can be exploited as biomarkers in liquid biopsy for early cancer detection, thereby increasing the life expectancy of cancer patients.
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Affiliation(s)
- Sidra Asghar
- Atta-ur -Rahman School of Applied Biosciences, National University of Sciences and Technology, Pakistan
| | - Fahed Parvaiz
- Department of Biosciences, COMSATS University, Islamabad, Pakistan
| | - Sobia Manzoor
- Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, H12, 44000 Islamabad, Pakistan.
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Wilhelm EN, Mourot L, Rakobowchuk M. Exercise-Derived Microvesicles: A Review of the Literature. Sports Med 2018; 48:2025-2039. [PMID: 29868992 DOI: 10.1007/s40279-018-0943-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Initially suggested as simple cell debris, cell-derived microvesicles (MVs) have now gained acceptance as recognized players in cellular communication and physiology. Shed by most, and perhaps all, human cells, these tiny lipid-membrane vesicles carry bioactive agents, such as proteins, lipids and microRNA from their cell source, and are produced under orchestrated events in response to a myriad of stimuli. Physical exercise introduces systemic physiological challenges capable of acutely disrupting cell homeostasis and stimulating the release of MVs into the circulation. The novel and promising field of exercise-derived MVs is expanding quickly, and the following work provides a review of the influence of exercise on circulating MVs, considering both acute and chronic aspects of exercise and training. Potential effects of the MV response to exercise are highlighted and future directions suggested as exercise and sports sciences extend the realm of extracellular vesicles.
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Affiliation(s)
- Eurico N Wilhelm
- School of Physical Education, UFPel, Rua Luís de Camões, 625, Três Vendas, Pelotas, RS, 96055-630, Brazil.
| | - Laurent Mourot
- EA3920 Prognostic Factors and Regulatory Factors of Cardiac and Vascular Pathologies, (Exercise Performance Health Innovation-EPHI), University of Bourgogne Franche-Comté, 25000, Besançon, France.,Tomsk Polytechnic University, Tomsk, Russia
| | - Mark Rakobowchuk
- Department of Biological Sciences, Faculty of Science, Thompson Rivers University, Kamloops, BC, Canada
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Dereli S, Bayramoğlu A, Yontar OC. Usefulness of platelet to lymphocyte ratio for predicting recurrence of atrial fibrillation after direct current cardioversion. Ann Noninvasive Electrocardiol 2018; 24:e12616. [PMID: 30414335 DOI: 10.1111/anec.12616] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 10/12/2018] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Atrial fibrillation (AF) is the most common cardiac rhythm disorder with the associated risks of stroke and mortality. The usefulness of platelet to lymphocyte ratio (PLR), a recently described inflammatory marker, in predicting adverse cardiovascular events has been demonstrated in several studies. In the current study, we investigated the role of PLR in predicting recurrence after successful electrical cardioversion (ECV) in patients with non-valvular persistent AF. METHODS A total of 287 patients with non-valvular persistent AF achieving restoration of the sinus rhythm after successful ECV were included in this study. At study entry, complete blood count, routine biochemistry tests, and transthoracic echocardiography (TTE) were performed routinely in all subjects. Patients were followed up for 6 months following the procedure and comparisons were performed between patients who recurred and who maintained the sinus rhythm (SR). RESULTS At 6 months of follow-up, AF recurred in 108 patients, corresponding to a recurrence rate of 39%. Mean PLR values in the "AF recurrence group" (mean age 57.4 ± 12.0 years, 47.6% [n = 80] female) and in "SR maintenance" group (mean age 65.0 ± 9.4 years, 55.6% [n = 60] female) were 184.8 ± 44.2 and 103.3 ± 44.2, respectively, with a significant difference between the two groups (p < 0.001). In multiple regression analyses, PLR emerged as a risk factor associated with AF recurrence during the 6-month follow-up period after successful ECV (odds ratio [OR]: 3.029 (1.013-9.055 95% confidence interval [CI]), p = 0.047). When a cutoff value of 147 was used, the sensitivity and specificity of PLR for predicting AF recurrence were 83.3% and 84.5%, respectively. CONCLUSION Elevated PLR is a marker of increased inflammation and may serve as a practical and inexpensive predictor for recurrence during 6 months of follow-up in patients with non-valvular persistent AF who had restoration of the sinus rhythm after successful ECV.
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Affiliation(s)
- Seçkin Dereli
- Department of Cardiology, Ordu State Hospital, Ordu, Turkey
| | - Adil Bayramoğlu
- Department of Cardiology, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Osman Can Yontar
- Department of Cardiology, Samsun Education and Research Hospital, Samsun, Turkey
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