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D'Italia G, Schroen B, Cosemans JM. Commonalities of platelet dysfunction in heart failure with preserved ejection fraction and underlying comorbidities. ESC Heart Fail 2025; 12:1013-1028. [PMID: 39375979 PMCID: PMC11911585 DOI: 10.1002/ehf2.15090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/06/2024] [Accepted: 09/06/2024] [Indexed: 10/09/2024] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is characterized by a lack of a specific targeted treatment and a complex, partially unexplored pathophysiology. Common comorbidities associated with HFpEF are hypertension, atrial fibrillation, obesity and diabetes. These comorbidities, combined with advanced age, play a crucial role in the initiation and development of the disease through the promotion of systemic inflammation and consequent changes in cardiac phenotype. In this context, we suggest platelets as important players due to their emerging role in vascular inflammation. This review provides an overview of the role of platelets in HFpEF and its associated comorbidities, including hypertension, atrial fibrillation, obesity and diabetes mellitus, as well as the impact of age and sex on platelet function. These major HFpEF-associated comorbidities present alterations in platelet behaviour and in features linked to platelet size, content and reactivity. The resulting dysfunctional platelets can contribute to further increase inflammation, oxidative stress and endothelial dysfunction, suggesting an active role of these cells in the initiation and progression of HFpEF. Recent evidence shows that reduced platelet count and elevated mean platelet volume are associated with worsening heart failure in HFpEF patients. However, the specific mechanisms by which platelets contribute to HFpEF development and progression are still largely unexplored, with only a few studies investigating platelet function in HFpEF. We discuss the limited yet significant body of research investigating platelet function in HFpEF, emphasizing the need for more comprehensive studies. Additionally, we explore the potential mechanisms through which platelets may influence HFpEF, such as their interactions with the vascular endothelium and the secretion of bioactive molecules like cytokines, chemokines and RNA molecules. These interactions and secretions may play a role in modulating vascular inflammation and contributing to the pathophysiological landscape of HFpEF. The review underscores the necessity for future research to elucidate the precise contributions of platelets to HFpEF, aiming to potentially identify novel therapeutic targets and improve patient outcomes. The evidence presented herein supports the hypothesis that platelets are not merely passive bystanders but active participants in the pathophysiology of HFpEF and its comorbidities.
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Affiliation(s)
- Giorgia D'Italia
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Blanche Schroen
- Department of Physiology, Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
| | - Judith M.E.M. Cosemans
- Department of Biochemistry, Cardiovascular Research Institute Maastricht (CARIM)Maastricht UniversityMaastrichtThe Netherlands
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2
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Mansoori A, Farizani Gohari NS, Etemad L, Poudineh M, Ahari RK, Mohammadyari F, Azami M, Rad ES, Ferns G, Esmaily H, Ghayour Mobarhan M. White blood cell and platelet distribution widths are associated with hypertension: data mining approaches. Hypertens Res 2024; 47:515-528. [PMID: 37880498 DOI: 10.1038/s41440-023-01472-y] [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: 01/23/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
In this paper, we are going to investigate the association between Hypertension (HTN) and routine hematologic indices in a cohort of Iranian adults. The data were obtained from a total population of 9704 who were aged 35-65 years, a prospective study was designed. The association between hematologic factors and HTN was assessed using logistic regression (LR) analysis and a decision tree (DT) algorithm. A total of 9704 complete datasets were analyzed in this cohort study (N = 3070 with HTN [female 62.47% and male 37.52%], N = 6634 without HTN [female 58.90% and male 41.09%]). Several variables were significantly different between the two groups, including age, smoking status, BMI, diabetes millitus, high sensitivity C-reactive protein (hs-CRP), uric acid, FBS, total cholesterol, HGB, LYM, WBC, PDW, RDW, RBC, sex, PLT, MCV, SBP, DBP, BUN, and HCT (P < 0.05). For unit odds ratio (OR) interpretation, females are more likely to have HTN (OR = 1.837, 95% CI = (1.620, 2.081)). Among the analyzed variables, age and WBC had the most significant associations with HTN OR = 1.087, 95% CI = (1.081, 1.094) and OR = 1.096, 95% CI = (1.061, 1.133), respectively (P-value < 0.05). In the DT model, age, followed by WBC, sex, and PDW, has the most significant impact on the HTN risk. Ninety-eight percent of patients had HTN in the subgroup with older age (≥58), high PDW (≥17.3), and low RDW (<46). Finally, we found that elevated WBC and PDW are the most associated factor with the severity of HTN in the Mashhad general population as well as female gender and older age.
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Affiliation(s)
- Amin Mansoori
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Applied Mathematics, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Leila Etemad
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohadeseh Poudineh
- Student of Research Committee, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Rana Kolahi Ahari
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mobin Azami
- Student of Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Elias Sadooghi Rad
- Student Research Committee, School of Medicine, Birjand University of Medical sciences, Birjand, Iran
| | - Gordon Ferns
- Brighton and Sussex Medical School, Division of Medical Education, Brighton, United Kingdom
| | - 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.
| | - Majid Ghayour Mobarhan
- International UNESCO center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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Lee T, Lee J, Shin DH, Lee H, Kim SK. Prognostic and Diagnostic Power of Delta Neutrophil Index and Mean Platelet Component in Febrile Patients with Suspected Sepsis. Biomedicines 2023; 11:3190. [PMID: 38137411 PMCID: PMC10740452 DOI: 10.3390/biomedicines11123190] [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: 11/01/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND The delta neutrophil index (DNI), a prognostic and diagnostic marker for sepsis, is based on the leukocyte count. Platelet activation, similar to leukocyte activation, plays a crucial role in host defense against pathogens and may serve as a predictor of sepsis outcome. However, the combined evaluation of mean platelet component (MPC) and DNI has rarely been used to assess sepsis. METHODS To assess the prognostic and diagnostic validity of the simultaneous evaluation of DNI and MPC in cases of human febrile sepsis, we conducted measurements of cellular indices, including DNI and MPC, as well as molecular biomarkers, including procalcitonin (PCT) and C-reactive protein (CRP). This study was carried out in patients admitted to the emergency department with suspected sepsis. RESULTS Using a cutoff value of 2.65%, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the DNI in sepsis were found to be 69%, 73.9%, 77.9%, and 64.1%, respectively. Furthermore, significant differences in DNI and MPC levels were observed between the sepsis and non-sepsis groups (6.7 ± 7.8% versus 2.1 ± 2.2% (p = 0.000) and 26.0 ± 1.9 g/dL versus 26.8 ± 1.4 g/dL (p = 0.002), respectively). Notably, there was a negative correlation between DNI and MPC, with the strength of the correlation varying based on the cause of sepsis. By setting the cutoff value of the DNI to 6.2%, its sensitivity, specificity, and NPV improved to 100%, 80.3%, and 100%, respectively, although the PPV remained at 10.6%. CONCLUSIONS In our study, the DNI demonstrates superior effectiveness compared with other molecular biomarkers, such as CRP and procalcitonin, in distinguishing septic febrile patients from non-septic febrile patients. Additionally, a negative correlation exists between MPC and DNI, making MPC a valuable marker for differentiating the etiology of sepsis. These findings hold significant clinical implications, as DNI/MPC evaluation is a cost-effective and readily applicable approach in various impending sepsis scenarios. Notably, this study represents the first examination of the prognostic and diagnostic validity of employing the simultaneous evaluation of DNI and MPC in human cases of febrile sepsis.
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Affiliation(s)
- Taehun Lee
- Department of Emergency Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Jongwook Lee
- Department of Laboratory Medicine, Konyang University Hospital, Daejeon 35465, Republic of Korea;
| | - Dong Hoon Shin
- Department of Laboratory Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea;
| | - Hyungdon Lee
- Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea
| | - Soo-Ki Kim
- Department of Microbiology, Wonju College of Medicine, Research Institute of Metabolism and Inflammation Research, Yonsei University, Wonju 26426, Republic of Korea
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Najjar AA, Hassouna I, Srour MA, Ibrahim HM, Assi RY, Abd El Latif HM. Evaluation of platelet parameters, coagulation markers, antiphospholipid syndrome, and thyroid function in palestinian women with recurrent pregnancy loss. BMC Pregnancy Childbirth 2023; 23:459. [PMID: 37340363 DOI: 10.1186/s12884-023-05764-6] [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: 11/26/2022] [Accepted: 06/06/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Multiple etiologies contribute to recurrent pregnancy loss (RPL) including immunological, endocrine, anatomical, genetic and infection but more than 50% of cases remain unexplained. Evidences of thrombotic and inflammatory processes were observed at maternal-fetal interface and considered pathological findings in most RPL cases including unexplained cases. This study aimed to evaluate the association between RPL and several risk factors: platelet parameters, coagulation factors, antiphospholipid syndrome, and thyroid function. METHODS This is an unmatched case-control study that included 100 RPL and 100 control women. Anthropometric and health data were collected and a gynecologist examined participants to assure fitting the inclusion criteria. Platelet parameters [including Mean Platelet Mass (MPM), Concentration (MPC) and Volume (MPV)] and ratios (MPV/Platelet, MPC/Platelet, MPM/Platelet, Platelet/Mononuclear cells), coagulation markers [Protein C (PC), Protein S (PS), Antithrombin III, D-dimer], antiphospholipid antibodies [Anti-phospholipid (APA), Anti-cardiolipin (ACA) and anti-B2-glycoprotein 1], Lupus anticoagulant, Antinuclear antibodies, and thyroid function (Thyroid stimulating hormone and anti-thyroid peroxidase) were measured. RESULTS Mean ages of cases and controls at marriage were 22.5 years for both, and their current ages were 29.4 and 33.0, respectively. 92% of cases and 99% of controls aged blow 30 years at marriage. 75% of cases have 3-4 miscarriages and 9% have ≥ 7 miscarriages. Our results indicated significantly lower male/female age ratio (p = .019), PC (p = .036) and PS (p = .025) in cases compared to controls. Plasma D-dimer (p = .020) and antiphospholipid antibodies [ACA (IgM and IgG), APA (IgM)] were significantly higher in cases compared to controls. No significant differences were observed between cases and controls concerning APA (IgG), anti-B2-glycoprotein 1 (IgM and IgG), Lupus anticoagulant, Antinuclear antibodies, platelet parameters, thyroid markers, family history of miscarriage, consanguineous marriage, and other health data. CONCLUSIONS This is the first study that investigated the association between platelet, coagulation, antiphospholipid, autoimmune and thyroid parameters, and RPL in Palestinian women. Significant associations between male/female age ratio, PC, PS, D-dimer, ACA (IgM, IgG), APA (IgM) and RPL were observed. These markers could be used in evaluating RPL. These findings confirm the heterogeneous nature of RPL and emphasize the need for further studies to find out risk factors for RPL.
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Affiliation(s)
- Ayman A Najjar
- Zoology Department, Faculty of Science, Menoufia University, Menoufia, Egypt
| | - Imam Hassouna
- Zoology Department, Faculty of Science, Menoufia University, Menoufia, Egypt
| | - Mahmoud A Srour
- Department of Biology and Biochemistry, Faculty of Science, Birzeit University, Birzeit, Palestine.
- Clinical Laboratory Science program, Faculty of Pharmacy, Nursing and Health Professions, Birzeit University, Birzeit, Palestine.
| | - Hany M Ibrahim
- Zoology Department, Faculty of Science, Menoufia University, Menoufia, Egypt.
| | - Randa Y Assi
- Department of Obstetrics & Gynecology, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Heba M Abd El Latif
- Zoology Department, Faculty of Science, Menoufia University, Menoufia, Egypt
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Hu J, Lv S, Zhou T, Chen H, Xiao L, Huang X, Wang L, Wu P. Identification of Pulmonary Hypertension Animal Models Using a New Evolutionary Machine Learning Framework Based on Blood Routine Indicators. JOURNAL OF BIONIC ENGINEERING 2022; 20:762-781. [PMID: 36466726 PMCID: PMC9703443 DOI: 10.1007/s42235-022-00292-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/17/2023]
Abstract
Pulmonary Hypertension (PH) is a global health problem that affects about 1% of the global population. Animal models of PH play a vital role in unraveling the pathophysiological mechanisms of the disease. The present study proposes a Kernel Extreme Learning Machine (KELM) model based on an improved Whale Optimization Algorithm (WOA) for predicting PH mouse models. The experimental results showed that the selected blood indicators, including Haemoglobin (HGB), Hematocrit (HCT), Mean, Platelet Volume (MPV), Platelet distribution width (PDW), and Platelet-Large Cell Ratio (P-LCR), were essential for identifying PH mouse models using the feature selection method proposed in this paper. Remarkably, the method achieved 100.0% accuracy and 100.0% specificity in classification, demonstrating that our method has great potential to be used for evaluating and identifying mouse PH models.
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Affiliation(s)
- Jiao Hu
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Shushu Lv
- Department of Dermatology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 People’s Republic of China
| | - Tao Zhou
- The First Clinical College, Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Huiling Chen
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Lei Xiao
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Xiaoying Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Liangxing Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Peiliang Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
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6
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Li T, Meng Z, Zhang W, Li Y, Yu X, Du X, Liu M, Zhang Q, Gao Y, Song K, Wang X, Fan Y. No obvious association exists between mean platelet volume and hypertension subtypes. Biomark Med 2021; 15:577-584. [PMID: 33988465 DOI: 10.2217/bmm-2020-0305] [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: 11/21/2022] Open
Abstract
Aims: To determine the association between mean platelet volume (MPV) and hypertension subtypes. Participants & results: 44,281 Chinese individuals were enrolled in this cross-sectional study. The mean blood pressure decreased with increasing MPV in females (p = 0.001) and increased MPV seemed to be a potential protective factor for isolated diastolic hypertension in models 1 and 2. The OR (CI) was 0.878 (0.789-0.976) for model 1 and 0.880 (0.789-0.981) for model 2 in males and 0.646 (0.495-0.841) for model 1 and 0.657 (0.503-0.858) for model 2 in females, when MPV was analyzed as a categorical variable. The OR (CI) was 0.947 (0.911-0.985) for Model 1 and 0.947 (0.910-0.985) for Model 2 in males, and 0.886 (0.807-0.973) for Model 1 and 0.892 (0.813-0.978) for Model 2 in females when MPV was analyzed as a continuous variable. However, the statistical difference of OR disappeared when we added blood-related covariates in Model 3. Conclusion: No obvious association exists between MPV and hypertension subtypes. Other blood parameters might have a greater impact on hypertension subtypes.
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Affiliation(s)
- Tingwei Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ming Liu
- Department of Endocrinology & Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis & Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
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7
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Zheng Y, Montague SJ, Lim YJ, Xu T, Xu T, Gardiner EE, Lee WM. Label-free multimodal quantitative imaging flow assay for intrathrombus formation in vitro. Biophys J 2021; 120:791-804. [PMID: 33513336 DOI: 10.1016/j.bpj.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/17/2020] [Accepted: 01/13/2021] [Indexed: 10/22/2022] Open
Abstract
Microfluidics in vitro assays recapitulate a blood vessel microenvironment using surface-immobilized agonists under biofluidic flows. However, these assays do not quantify intrathrombus mass and activities of adhesive platelets at the agonist margin and use fluorescence labeling, therefore limiting clinical translation potential. Here, we describe a label-free multimodal quantitative imaging flow assay that combines rotating optical coherent scattering microscopy and quantitative phase microscopy. The combined imaging platform enables real-time evaluation of membrane fluctuations of adhesive-only platelets and total intrathrombus mass under physiological flow rates in vitro. We call this multimodal quantitative imaging flow assay coherent optical scattering and phase interferometry (COSI). COSI records intrathrombus mass to picogram accuracy and shape changes to a platelet membrane with high spatial-temporal resolution (0.4 μm/s) under physiological and pathophysiological fluid shear stress (1800 and 7500 s-1). With COSI, we generate an axial slice of 4 μm from the coverslip surface, approximately equivalent to the thickness of a single platelet, which permits nanoscale quantification of membrane fluctuation (activity) of adhesive platelets during initial adhesion, spreading, and recruitment into a developing thrombus (mass). Under fluid shear, pretreatment with a broad range metalloproteinase inhibitor (250 μM GM6001) blocked shedding of platelet adhesion receptors that shown elevated adhesive platelet activity at average of 42.1 μm/s and minimal change in intrathrombus mass.
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Affiliation(s)
- Yujie Zheng
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research
| | - Samantha J Montague
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research
| | - Yean J Lim
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research; ACRF Centre for Intravital Imaging of Niches for Cancer Immune Therapy
| | - Tao Xu
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research
| | - Tienan Xu
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research
| | - Elizabeth E Gardiner
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research
| | - Woei Ming Lee
- ACRF Department of Cancer Biology and Therapeutics, John Curtin School of Medical Research; ACRF Centre for Intravital Imaging of Niches for Cancer Immune Therapy; The ARC Centre of Excellence in Advanced Molecular Imaging, The Australian National University, Canberra, Australia.
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8
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Prognostic value of neutrophil/lymphocyte ratio and mean platelet volume/platelet ratio for 1-year mortality in critically ill patients. Sci Rep 2020; 10:21513. [PMID: 33299038 PMCID: PMC7726551 DOI: 10.1038/s41598-020-78476-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/25/2020] [Indexed: 02/06/2023] Open
Abstract
Several studies have reported that the neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) are associated with poor prognosis. This study investigated whether NLR and/or the MPV/platelet ratio could function as predictive markers of mortality in critically ill patients. We retrospectively reviewed 1,154 patients admitted to the intensive care unit (ICU) between January 2017 and December 2017. Patients were divided into 2 groups according to 1-year mortality. We compared the NLR and MPV/platelet ratio on each day of ICU admission. Patients were classified into tertiles based on their NLR and MPV/platelet ratios, and the incidence of 1-year mortality was compared. Kaplan-Meier survival curves were plotted to evaluate their potential as prognostic factors for 1-year mortality. The NLR and MPV/platelet ratio were higher in the non-survivor group than in the survivor group. The incidence of 1-year mortality was the highest in the third tertile for both the NLR and MPV/platelet ratio. The MPV/platelet ratio was an independent predictor for 1-year mortality based on the Kaplan-Meier survival analysis. Our data showed that the MPV/platelet ratio is a predictive factor for 1-year mortality in critically ill patients.
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9
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Kurtul BE, Çakmak Aİ, Elbeyli A, Özarslan Özcan D, Özcan SC, Cankurtaran V. Assessment of platelet-to-lymphocyte ratio in patients with retinal vein occlusion. Ther Adv Ophthalmol 2020; 12:2515841420971949. [PMID: 33283155 PMCID: PMC7686591 DOI: 10.1177/2515841420971949] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/15/2022] Open
Abstract
Purpose: To investigate platelet-to-lymphocyte ratio (PLR) in retinal vein occlusion
(RVO) patients. Methods: In this study, we retrospectively reviewed data of 32 patients with RVO (RVO
group) and 32 age- and sex-matched participants without RVO (control group)
between January 2017 and March 2019. The PLR was determined by dividing the
platelet count by the lymphocyte count. Results: Age and gender were comparable between the groups (p = 0.204
and p = 0.800, respectively). PLR was significantly
elevated in the RVO group compared with the control group (137 (113–164) vs
101 (86–129), p = 0.001)). In the receiver operator
characteristics curve analysis, the optimal cut-off value of PLR for
predicting RVO was 123, with 69% sensitivity and 72% specificity. Conclusion: We report that PLR are elevated in RVO, suggesting that PLR may be a useful
marker for RVO.
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Affiliation(s)
- Bengi Ece Kurtul
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, 31060, Alahan, Hatay, Turkey
| | - Ayșe İdil Çakmak
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Ahmet Elbeyli
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Deniz Özarslan Özcan
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Sait Coșkun Özcan
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
| | - Veysel Cankurtaran
- Department of Ophthalmology, Tayfur Ata Sökmen Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey
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10
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Chen X, Li J, Zhang X, Liu Y, Wu J, Li Y, Cui X, Jiang X. Prognostic and clinicopathological significance of pretreatment mean platelet volume in cancer: a meta-analysis. BMJ Open 2020; 10:e037614. [PMID: 33109647 PMCID: PMC7592286 DOI: 10.1136/bmjopen-2020-037614] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Our study aimed to evaluate the prognostic and clinicopathological significance of pretreatment mean platelet volume (MPV) on cancer by using meta-analysis of published studies. DESIGN Meta-analysis. DATA SOURCES Relevant studies available before 22 December 2019 were identified by searching MEDLINE, EMBASE. ELIGIBILITY CRITERIA All published studies that assessed the prognostic and clinicopathological significance of pretreatment MPV on cancer were included. DATA EXTRACTION AND SYNTHESIS Studies were identified and extracted by two reviewers independently. The HR/OR and its 95% CIs of survival outcomes and clinicopathological parameters were calculated. RESULTS A total of 38 eligible studies (41 subsets) with 9894 patients with cancer were included in the final meta-analysis. MPV level was not significantly associated with both overall survival (HR 0.98, 95% CI 0.84 to 1.14) and disease-free survival (HR 1.22, 95% CI 0.86 to 1.73) of patients with cancer. Neither advanced nor mixed-stage tumour patients showed significant association between MPV and overall survival (HR 1.36, 95% CI 0.96 to 1.94, HR 0.90, 95% CI 0.74 to 1.09). However, high MPV had the strongest relationship with poor overall survival (HR 2.01; 95% CI 1.08 to 3.41) in gastric cancer, followed by pancreatic cancer (HR 1.54; 95% CI 1.31 to 1.82). Whereas in the subgroup using receiver operating characteristic curve method to define cut-off values, low MPV was significantly related to poor overall survival (HR 0.78, 95% CI 0.64 to 0.95). In addition, MPV had no significant association with age (OR 0.96, 95% CI 0.90 to 1.02), sex (OR 1.04, 95% CI 1.00 to 1.09), depth of cancer invasion (OR 0.90, 95% CI 0.77 to 1.04) and tumour stage (OR 0.91, 95% CI 0.78 to 1.07). CONCLUSIONS Pretreatment MPV level is of no clearly prognostic significance in cancers and no significant association with clinicopathological parameters of patients with cancers.
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Affiliation(s)
- Xin Chen
- Department of General Surgery, Nantong Tumor Hospital, Nantong, China
- Department of General Surgery, Tumor Hospital Affiliated to Nantong University, Nantong, China
| | - Jing Li
- Cancer Research Center Nantong, Nantong Tumor Hospital, Nantong, China
- Cancer Research Center Nantong, Nantong Tumor Hospital, Nantong Jiangsu, Nantong, China
| | - Xunlei Zhang
- Department of Oncology, Nantong Tumor Hospital, Nantong, China
- Department of Oncology, Tumor Hospital Affiliated to Nantong University, Nantong, China
| | - Yushan Liu
- Department of Pathology, Nantong Tumor Hospital, Nantong, China
| | - Jindong Wu
- Department of General Surgery, Nantong Tumor Hospital, Nantong, China
| | - Yangcheng Li
- Department of General Surgery, Nantong Tumor Hospital, Nantong, China
| | - Xiaopeng Cui
- Department of Gastrointestinal Surgery, Nantong University Affiliated Hospital, Nantong, China
| | - Xiaohui Jiang
- Department of General Surgery, Nantong Tumor Hospital, Nantong, China
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Buch A, Kaur S, Nair R, Jain A. Platelet volume indices as predictive biomarkers for diabetic complications in Type 2 diabetic patients. J Lab Physicians 2020; 9:84-88. [PMID: 28367021 PMCID: PMC5320886 DOI: 10.4103/0974-2727.199625] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND: Platelet volume indices (PVI) such as mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR) are the indicators of increased platelet activity and can be considered as potential biomarkers for diabetic complications. PURPOSE: To study PVI in Type 2 diabetics with and without complications in comparison to nondiabetic patients. MATERIALS AND METHODS: A case–control study was conducted on 300 Type 2 diabetics and 200 nondiabetics. Detailed clinical history regarding duration, hypertension, and complications was taken. PVI was obtained using automated cell counter. Fasting blood glucose, hemoglobin A1c, lipid profile, creatinine were also obtained. Diabetics were further categorized into patients with complications and without complications. Statistical analysis was performed by Statistical Package for the Social Sciences Version 17 (Chicago, IL) Student's t-test and ANOVA test. RESULTS: Platelet count was significantly decreased in diabetics (P = 0.005). MPV was significantly increased in diabetic patients with complications as compared to diabetics without complications and nondiabetic group (P < 0.0001). PDW showed statistically significant difference between diabetics with and without complications and nondiabetics (P < 0.0001). However, no statistically significant difference was observed in platelet-large cell ratio (P-LCR) among all the three study groups. We found statistically significant correlation of MPV with diabetic retinopathy (P = 0.000), nephropathy (P = 0.005), and diabetic foot (P = 0.048). PDW was significantly increased in diabetic retinopathy (P = 0.035) and nephropathy (P = 0.007). P-LCR had no statistically significant correlation with diabetic complications. CONCLUSION: MPV and PDW are predictive biomarkers of diabetic vascular complications. They are more significant in microvascular complications than macrovascular complications.
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Affiliation(s)
- Archana Buch
- Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Supreet Kaur
- Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Rahul Nair
- Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
| | - Ambuj Jain
- Department of Pathology, Dr. D. Y. Patil Medical College Hospital and Research Centre, Pimpri, Pune, Maharashtra, India
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Effects of statin therapy on mean platelet volume in patients with risk of cardiovascular diseases: a systematic review and meta-analysis. Biosci Rep 2019; 39:BSR20190180. [PMID: 31285388 PMCID: PMC6658723 DOI: 10.1042/bsr20190180] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 06/03/2019] [Accepted: 06/27/2019] [Indexed: 02/06/2023] Open
Abstract
Many studies have demonstrated the effects of statin therapy on platelet, but it is controversial that whether statin could reduce mean platelet volume (MPV) in patients with the risk of cardiovascular diseases. To further improve the clinical significance of MPV in those patients and explore new function of statin, we conducted this research. Relevant studies were selected by searching electronic databases (PubMed, Embase and Cochrane Library) and reference lists of related articles by hand. Two reviewers independently assessed eligibility and quality of the studies. Eventually, we included ten studies, a total of 1189 patients with the risk of cardiovascular diseases. Consolidating relevant data and comparing the changes of MPV before and after statin treatment, we found that statin could decrease MPV [standard mean difference (SMD) = −0.47 (−0.71–0.23)], which was statistically significant (P=0.0001). Subgroup analysis suggested that when ≥55 years, this decrease did not occur [SMD = −0.06 (−0.18, 0.06)]. Drug type, sample size, ethnicity, mean age and quality of included article were sources of heterogeneity. Therefore, statin therapy could reduce MPV significantly and exhibited antiplatelet activity, which is of great importance in clarifying the clinical significance of MPV in cardiovascular events and the prevention of cardiovascular events.
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Investigation of Blood Characteristics in Nonsyndromic Retinitis Pigmentosa: A Retrospective Study. J Ophthalmol 2019; 2019:1902915. [PMID: 31191992 PMCID: PMC6525908 DOI: 10.1155/2019/1902915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/10/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the characteristics of blood in nonsyndromic retinitis pigmentosa (RP) and reveal the pathogenesis of blood cells involved in blood stasis in RP. Design This is a retrospective observational study. Methods We collected vein blood from 101 cases of patients with nonsyndromic RP and 120 cases of normal individuals according to a single-blind study and used routine clinical examination to detect the indicators of blood. All the subjects were mainly from the central south of China. Data were analyzed statistically between the RP group and normal control. Results The indicator of platelet distribution width (PDW) in patients with RP was higher than that in the normal group; the indicators of red blood cell (RBCs), hemoglobin (HGB), hematocrit (HCT), basophils (BASs), platelets (PLTs), and plateletcrit (PCT) in the RP group were lower than those in the normal control. The differences were statistically very significant between the RP group and normal group (p < 0.01). There were no statistical differences in the other indicators between the RP and normal group. Conclusions The changes in RBCs and PLTs in patients with RP implied that RP induces RBC aggregation and platelet activation, leading to blood stasis which in turn initiates more apoptosis.
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Batista TR, Figueiredo RCD, Rios DRA. Platelets volume indexes and cardiovascular risk factors. ACTA ACUST UNITED AC 2018; 64:554-559. [PMID: 30304315 DOI: 10.1590/1806-9282.64.06.554] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 09/25/2017] [Indexed: 11/21/2022]
Abstract
Obesity, diabetes and hypertension are risk factors for cardiovascular diseases (CVD) because they promote a state of hypercoagulability. It is known that platelets play an important role in the development of atherosclerosis. Recent studies have evaluated platelet volume indexes (PVIs) in individuals with risk factors for CVD to better understand the platelet mechanisms involved in their development. The IVPs indirectly estimate platelet function and are easily obtained from automated hematology analyzers, which provide platelet counts, mean platelet volume (MPV), platelet distribution width (PDW) and the platelet-large cell ratio (P-LCR). The present study aims to review literature studies that investigated the association between PVIs and obesity, diabetes, and arterial hypertension, in order to evaluate its use as a potential subclinical marker of CVD. Studies have shown promising results for MPV, an index that allows for early detection of platelet activation and may be useful in identifying patients before the onset of CVD development so that preventive strategies can be implemented. The PDW, although evaluated by a smaller number of studies, also showed promising results. However, there is still a long way to go in order for the MPV and PDW to be used in clinical practice, since there is still a need for more epidemiological evidence, establishing reference values, and standardizing the way results are presented.
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Affiliation(s)
- Thaís Resende Batista
- Dona Lindu Center West Campus, Federal University of São João del-Rei, São João del Rei MG, Brasil
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15
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Gundogmus İ, Algul A, Karagöz A, Kıyançiçek M. PDW and RDW are new parameters for bipolar episodes and unipolar depression. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1468616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Affiliation(s)
- İbrahim Gundogmus
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayhan Algul
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Abdulkadir Karagöz
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Murat Kıyançiçek
- Department of Psychiatry, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
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Abudesimu A, Liu F, Siti D, Adi D, Fu Z, Ma X, Xie X, Yang Y, Li X, Ma Y. An assessment of platelet parameters in different ethnic groups with hypertension subtypes and associated risk factors in Xinjiang, China. Clin Exp Hypertens 2018; 40:574-581. [PMID: 29420092 DOI: 10.1080/10641963.2017.1411494] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The goal of this study was to investigate platelet parameters in populations with hypertension subtypes among the Han, Uygur, and Kazakh ethnic groups and their associated risk factors in Xinjiang, northwestern China. In total, 9816 adult participants were recruited from a multiethnic, cross-sectional cardiovascular risk survey. Our results indicated that the platelet counts in Han, Uygur, and Kazakh participants with isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH), and systolic diastolic hypertension (SDH) varied significantly (P < 0.001). Additionally, the mean platelet volume (MPV) in Han, Uygur, and Kazakh participants with ISH was significantly different (P < 0.05). Furthermore, the individual platelet parameters had different associated risk factors. For example, the risk factors for platelet counts were Uygur ethnicity, Kazakh ethnicity, drinking, ISH, diabetes, and high triglycerides (TGs). The risk factors for MPV were Uygur ethnicity, smoking, overweight, obesity, ISH, IDH, diabetes, and high TGs. Gender was a risk factor for abnormal plateletcrit (PCT) values. Only a low high-density lipoprotein cholesterol level was found to be a risk factor for platelet distribution width (PDW). We suggest that more attention should be paid to platelet parameters and the associated risk factors to reinforce the effect of antiplatelet therapy and to provide a clinical basis for preventing the occurrence of thrombosis complications and cerebro- and cardiovascular diseases effectively.
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Affiliation(s)
- Asiya Abudesimu
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Fen Liu
- b Xinjiang Key Laboratory of Cardiovascular Disease , Clinical Medical Research Institute of First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Dilixiati Siti
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Dilare Adi
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Zhenyan Fu
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Xiang Ma
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Xiang Xie
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Yining Yang
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Xiaomei Li
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
| | - Yitong Ma
- a Department of Cardiovascular Medicine , First Affiliated Hospital of Xinjiang Medical University , Urumqi , PR China
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Sepúlveda C, Palomo I, Fuentes E. Antiplatelet activity of drugs used in hypertension, dyslipidemia and diabetes: Additional benefit in cardiovascular diseases prevention. Vascul Pharmacol 2017; 91:10-17. [DOI: 10.1016/j.vph.2017.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/03/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023]
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Ates I, Bulut M, Ozkayar N, Dede F. Association between high platelet indices and proteinuria in patients with hypertension. Ann Lab Med 2016; 35:630-4. [PMID: 26354352 PMCID: PMC4579108 DOI: 10.3343/alm.2015.35.6.630] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/13/2015] [Accepted: 08/03/2015] [Indexed: 11/19/2022] Open
Abstract
Background We aimed to determine the association between platelet indices including plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and proteinuria associated with hypertension (HT) as well as the relative power of each to predict proteinuria. Methods The study included 223 patients (68 men and 155 women) with primary HT. PCT, MPV, PDW, and proteinuria levels were measured. The patients were divided into two groups according to proteinuria status based on 24-hr urinary protein excretion: proteinuria (+) group (15 men and 40 women) and proteinuria (-) group (53 men and 115 women). Results The mean and SD of platelet count, PDW, PCT, and MPV were 278.8±49.6×109/L, 13.5±1.8%, 0.31±0.07%, and 11.3±2.6 fL, respectively. The mean platelet count, PCT, MPV, and PDW were significantly higher in the proteinuria (+) group than in the proteinuria (-) group (P<0.05); there were no significant differences in the other blood parameters between the two groups. The platelet count, PCT, MPV, and PDW were independent risk factors predictive of proteinuria according to a stepwise regression analysis of PDW, PCT, and MPV. PCT was the strongest independent predictor of proteinuria. Conclusions The platelet indices PCT, PDW, and MPV were significantly higher in patients with proteinuria than in those without it. Among these three indices, PCT was the strongest predictor of proteinuria.
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Affiliation(s)
- Ihsan Ates
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Mesudiye Bulut
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Nihal Ozkayar
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey.
| | - Fatih Dede
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
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20
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Celik T, Balta S, Ozturk C, Unlu M, Iyisoy A. Platelet Indices in Patients With Acute Coronary Syndromes: A Bedside Marker of Prognosis? Angiology 2016; 67:697-8. [PMID: 26987763 DOI: 10.1177/0003319716638796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Turgay Celik
- Department of Cardiology, Gulhane Military Medical Academy School of Medicine, Etlik-Ankara, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Military Medical Academy School of Medicine, Etlik-Ankara, Turkey
| | - Cengiz Ozturk
- Department of Cardiology, Gulhane Military Medical Academy School of Medicine, Etlik-Ankara, Turkey
| | - Murat Unlu
- Department of Cardiology, Gulhane Military Medical Academy School of Medicine, Etlik-Ankara, Turkey
| | - Atila Iyisoy
- Department of Cardiology, Gulhane Military Medical Academy School of Medicine, Etlik-Ankara, Turkey
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21
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Assessment of Hematological Factors Involved in Development and Prognosis of Idiopathic Sudden Sensorineural Hearing Loss. J Craniofac Surg 2016; 27:e85-91. [PMID: 26703036 DOI: 10.1097/scs.0000000000002241] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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22
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Maluf CB, Barreto SM, dos Reis RC, Vidigal PG. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ACTA ACUST UNITED AC 2016; 54:879-87. [DOI: 10.1515/cclm-2015-0686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.
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23
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Ulucan Ş, Keser A, Kaya Z, Katlandur H, Özdil H, Bilgi M, Ateş İ, Ülgen MS. Association between PDW and Long Term Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome. Heart Lung Circ 2015; 25:29-34. [PMID: 26166174 DOI: 10.1016/j.hlc.2015.05.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 05/11/2015] [Accepted: 05/14/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of the present study was to perform a preliminary evaluation of the potential association between platelet distribution width (PDW) and frequency of major adverse cardiovascular events (MACEs) development in an observational study of acute coronary syndrome (ACS) patients. METHODS A total of 679 consecutive patients with ACS (498 (73.3%) males; mean age was 63.31±11.2 years; study population composed of 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) subjected to primary percutaneous coronary intervention with transradial approach (TRA) were retrospectively enrolled to the study. Tertiles were formed based on PDW levels. The associations between PDW and in-hospital and long-term MACEs were analysed. RESULTS The frequencies of in-hospital instent thrombosis (P=0.05), long-term instent restenosis (P=0.005) and long-term total MACEs (P=0.008) were higher in tertiles having a high PDW value. In multivariate analyses, PDW was an independent predictor of in-hospital and long-term MACEs (odds ratio 1.081, 95% confidence interval 1.003-1.165; p=0.042). The projected Kaplan-Meier incidence of a MACEs in the PDW tertiles groups were 12.8%, 12.1%, and 21.6% at 40 months (respectively, p=0.003). CONCLUSIONS The pre-procedural PDW may be an independent predictor of both in-hospital and long-term adverse outcomes in patients with ACS.
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Affiliation(s)
- Şeref Ulucan
- Department of Cardiology, Mevlana University, Konya, Turkey
| | - Ahmet Keser
- Department of Cardiology, Mevlana University, Konya, Turkey
| | - Zeynettin Kaya
- Department of Cardiology, Mevlana University, Konya, Turkey.
| | | | - Hüseyin Özdil
- Department of Cardiology, Mevlana University, Konya, Turkey
| | - Mustafa Bilgi
- Department of Internal Medicine, Mevlana University, Konya, Turkey
| | - İsmail Ateş
- Department of Cardiology, Kazakh National University of S.D. Asfendiyarov, Almaty, Kazakhstan
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Patel RS, Sharma KH, Kamath NA, Patel NH, Thakkar AM. Cost-effectiveness analysis of nebivolol and metoprolol in essential hypertension: a pharmacoeconomic comparison of antihypertensive efficacy of beta blockers. Indian J Pharmacol 2015; 46:485-9. [PMID: 25298575 PMCID: PMC4175882 DOI: 10.4103/0253-7613.140577] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 05/16/2014] [Accepted: 08/05/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To estimate and compare the cost-effectiveness and safety of nebivolol with sustained-release metoprolol in reducing blood pressure by 1 mm of Hg per day in hypertensive patients. MATERIALS AND METHODS This was a prospective, randomized, open label, observational analysis of cost-effectiveness, in a questionnaire-based fashion to compare the cost of nebivolol (2.5 mg, 5 mg, 10 mg) and sustained released metoprolol succinate (25 mg, 50 mg, 100 mg) in hypertensive patients using either of the two drugs. A total of 60 newly detected drug naïve hypertensive patients were considered for the comparison, of which 30 patients were prescribed nebivolol and the other 30 were prescribed metoprolol succinate as per the recommended dosage. Based on the data, statistical analysis was carried out using GraphPad Prism 5 and MS Excel Spreadsheet 2007. RESULT The cost of reducing 1 mm of Hg blood pressure per day with nebivolol was 0.60, 0.70, and 1.06 INR, whereas that of metoprolol succinate was 0.93, 1.18, and 1.25 INR at their respective equivalent doses, hence significantly lower with the nebivolol group as compared to the metoprolol group (P < 0.05). CONCLUSION This pharmacoeconomic analysis shows that nebivolol is more cost-effective as compared to metoprolol when the cost per reduction in blood pressure per day is considered. This may affect the patients economically during their long-term use of these molecules for the treatment of hypertension.
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Affiliation(s)
- Rachna S Patel
- Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India
| | - Kamal H Sharma
- U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, India
| | | | - Nirav H Patel
- Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India
| | - Ankita M Thakkar
- Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India
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Karabulut A, Karadag A. Clinical implication of hematological indices in the essential hypertension. World J Hypertens 2015; 5:93-97. [DOI: 10.5494/wjh.v5.i2.93] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Revised: 03/10/2015] [Accepted: 04/20/2015] [Indexed: 02/06/2023] Open
Abstract
Prognostic value of haematological indices, especially red cell distribution width, neutrophil lymphocyte ratio and mean platelet volume, was reported with numerous investigations in miscellaneous cardiovascular settings. Their major prognostic value was linked to oxidative stress and inflammation since their level was correlated with major inflammatory markers such as high sensitive C-reactive protein and interleukins. Oxidative stress and chronic inflammation are also postulated as the main pathophysiologic mechanism of essential hypertension (HT) and its vascular complication. Recently, correlation between HT and haematological parameters was searched in numerous studies, which has made the topic more popular. Herein, we reveal the correlation between haematological indices and HT and we also demonstrate the clinical implication of this correlation. Impaired haematological parameters may strongly indicate hypertensive end-organ damage.
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Güneş M, Umul M, Altok M, Akyuz M, İşoğlu CS, Uruc F, Aras B, Akbaş A, Baş E. Predictive role of hematologic parameters in testicular torsion. Korean J Urol 2015; 56:324-9. [PMID: 25874047 PMCID: PMC4392033 DOI: 10.4111/kju.2015.56.4.324] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 02/13/2015] [Indexed: 01/30/2023] Open
Abstract
Purpose To evaluate the predictive role of the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet count (PLT) in the diagnosis of testicular torsion (TT) and testicular viability following TT. Materials and Methods We analyzed two study groups in this retrospective study: 75 patients with a diagnosis of TT (group 1) and 56 age-matched healthy subjects (group 2). We performed a complete blood count as a part of the diagnostic procedure, and NLR, PLR, MPV, and PLT values were recorded. We compared the patient and control groups in terms of these parameters. Then, TT patients were divided into two subgroups according to the time elapsed since the onset of symptoms. Subsequently, we evaluated the relationship between the duration of symptoms and these parameters. Results There were significant differences between groups 1 and 2 in NLR, PLR, and PLT (p<0.001 for all). There was no predictive role of MPV in the diagnosis of TT (p=0.328). We determined significantly high sensitivity and specificity levels for NLR in the prediction of TT diagnosis (84% and 92%, respectively). Furthermore, NLR was significantly related to the duration of symptoms in TT patients (p=0.01). Conclusions NLR may be a useful parameter in the diagnosis of TT. Furthermore, NLR may be used as a predictive factor for testicular viability following TT.
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Affiliation(s)
- Mustafa Güneş
- Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Mehmet Umul
- Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Muammer Altok
- Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Mehmet Akyuz
- Department of Urology, Haydarpasa Training and Research Hospital, İstanbul, Turkey
| | - Cemal Selcuk İşoğlu
- Department of Urology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Fatih Uruc
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Bekir Aras
- Department of Urology, Dumlupınar University, Faculty of Medicine, Kütahya, Turkey
| | - Alpaslan Akbaş
- Department of Urology, Canakkale Onsekiz Mart University, Faculty of Medicine, Çanakkale, Turkey
| | - Ercan Baş
- Department of Urology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
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Usluoğullari B, Kaygusuz I, Simavli S, Eser A, Inegol Gumus İ. Effects of cesarean section on mean platelet volume. Platelets 2014; 26:657-60. [PMID: 25350688 DOI: 10.3109/09537104.2014.974152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mean platelet volume (MPV) is a risk factor for cardiovascular complications, cerebrovascular disorders, and low-grade inflammatory conditions prone to arterial and venous thromboses. Cesarean delivery is the most important risk factor for pulmonary embolism, stroke, and intracranial venous thrombosis. The hypothesis is that increase in the prevalence of cesarean section and high MPV may be associated with cardiovascular complications such as stroke along with intracranial complications in addition to known systemic and surgical complications. In this study, platelet counts and MPV for postpartum women who delivered by cesarean section and normal vaginal parturition are compared. The subjects were divided in two groups, one was study group consisting of 118 patients giving birth by cesarean section and the other was the control group consisting 94 patients giving birth by normal vaginal parturition. Peripheral venous blood samples in EDTA tubes were collected from all the subjects 1 week before and after the delivery for their prenatal and postpartum periods, respectively. The values were compared between the groups and also before and after the delivery. In the cesarean group, while the MPV level was 8.60 (1.64) fl in the prenatal period, it increased to 9.10 (2.00) fl in the postnatal period (p < 0.001). Group effect, time effect (independent from group effect), and group*time interaction effect were statistically significant for MPV variable (p = 0.032, p < 0.001, and p = 0.012, respectively). This study concluded that MPV, along with several other factors, may be used as a prognostic, independent, and therapeutic marker in patients who are inclined to thrombotic events after cesarean section.
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Affiliation(s)
- Betül Usluoğullari
- a Cengiz Gokcek Obstetric and Gynecology State Hospital , Gaziantep , Turkey and
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Cid J, Magnano L, Molina P, Diaz-Ricart M, Martínez N, Maymó RM, Puig L, Lozano M, Escolar G, Galán AM. Automated preparation of whole blood-derived platelets suspended in two different platelet additive solutions and stored for 7 days. Transfusion 2014; 54:426-33. [PMID: 23721299 DOI: 10.1111/trf.12283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 04/30/2013] [Accepted: 04/30/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The Atreus system (Terumo BCT) automates the preparation of blood components from whole blood donations. Intermediate platelet (PLT) products can be pooled manually or with the OrbiSac (Terumo BCT) and suspended in different PLT additive solutions (PASs) to obtain PLT concentrates (PCs). The aim of our study was to compare the in vitro PLT quality of PCs obtained with either the Atreus 2C+ and the OrbiSac or the Atreus 3C and suspended in PAS-II or PAS-IIIM during storage for up to 7 days. STUDY DESIGN AND METHODS We prepared eight PCs from buffy coats obtained with Atreus 2C+, pooled with the OrbiSac, and suspended in PAS-II and eight PCs from interim PLT units obtained with the Atreus 3C and suspended either in PAS-II or in PAS-IIIM. We measured volume, PLT content, and mean PLT component and performed metabolic assays (pH, glucose, lactate, pO₂, and pCO₂) and flow cytometry analyses (GPIb, GPIIbIIIa, GPIV, CD62P, CD63, von Willebrand factor [vWF], fibrinogen, Factor V, and annexin V). RESULTS PCs prepared with the Atreus 3C showed lower volume and higher PLT concentration when compared with PCs prepared with the Atreus 2C+ and the OrbiSac (p < 0.05). Glucose consumption rate and the expression of CD62P, CD63, and vWF were lower in PCs suspended in PAS-IIIM when compared with PCs suspended in PAS-II (p < 0.05). CONCLUSION PCs prepared with the Atreus 3C and suspended in PAS-IIIM preserve satisfactorily the in vitro PLT quality during 7-day storage. PLT activation during a 7-day storage period was lower when the storage solution was PAS-IIIM in comparison with PAS-II.
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Affiliation(s)
- Joan Cid
- Department of Hemotherapy and Hemostasis, CDB, IDIBAPS, Hospital Clínic, University de Barcelona; and the Banc de Sang i Teixits, Barcelona, Spain
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Leal-Santos FA, Silva SBR, Crepaldi NP, Nery AF, Martin TOG, Alves-Junior ER, Fontes CJF. Altered platelet indices as potential markers of severe and complicated malaria caused by Plasmodium vivax: a cross-sectional descriptive study. Malar J 2013; 12:462. [PMID: 24370274 PMCID: PMC3893420 DOI: 10.1186/1475-2875-12-462] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 12/20/2013] [Indexed: 12/31/2022] Open
Abstract
Background This study described altered platelet indices in patients with acute malaria caused by Plasmodium vivax and determined whether these alterations are associated with warning signs of severe and complicated malaria. Methods A total of 186 patients attending the Malaria Clinic at the University Hospital from the Federal University of Mato Grosso, Brazil, between 2008 and 2013 were included in this study. After parasitological confirmation of exclusive infection by P. vivax, blood cell counts and platelet indices were determined. Disease gravity was evaluated on the basis of classic signs of Plasmodium falciparum severe malaria, including severe anemia, or by changes in serum levels of glucose, bilirubin, aminotransferases and creatinine at the time of the patient’s admission. Patients with a longer duration of symptoms or those identified as primo infected were considered potential candidates for evolution into the severe form of malaria. Results The mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) values exhibited significant variability. A significant inverse relationship was observed between parasitaemia and PCT. Patients with warning signs for evolution into severe disease, with primo infection, or presenting with symptoms for over three days had the highest MPV and PDW. The adjusted analyses showed the presence of warning signs for the development of severe and complicated malaria remained independently linked to elevated MPV and PDW. Conclusion Altered platelet indices should be analysed as potential markers for the severity of malaria caused by P. vivax. Future studies with appropriate methodology for prognostic evaluation could confirm the potential use of these indices in clinical practice.
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Affiliation(s)
- Fábio A Leal-Santos
- Malaria Clinic, University Hospital of Federal University of Mato Grosso, Rua Luis Phelippe Pereira Leite, s/n, Alvorada, Cuiabá (MT) CEP: 78048-902, Brazil.
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Celik T, Kaya MG, Akpek M, Gunebakmaz O, Balta S, Sarli B, Duran M, Demirkol S, Uysal OK, Oguzhan A, Gibson CM. Predictive Value of Admission Platelet Volume Indices for In-hospital Major Adverse Cardiovascular Events in Acute ST-Segment Elevation Myocardial Infarction. Angiology 2013; 66:155-62. [DOI: 10.1177/0003319713513493] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Although mean platelet volume (MPV) is an independent correlate of impaired angiographic reperfusion and 6-month mortality in ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), there is less data regarding the association between platelet distribution width (PDW) and in-hospital major adverse cardiovascular events (MACEs). A total of 306 patients with STEMI pPCI were evaluated. No reflow was defined as a post-PCI thrombolysis in myocardial infarction (TIMI) flow grade of 0, 1, or 2 (group 1). Angiographic success was defined as TIMI flow grade 3 (group 2). The values of MPV and PDW were higher among patients with no reflow. In-stent thrombosis, nonfatal myocardial infarction, in-hospital mortality, and MACEs were significantly more frequent among patients with no reflow. In multivariate analysis, PDW, MPV, high-sensitivity C-reactive protein, and glucose on admission were independent correlates of in-hospital MACEs. Admission PDW and MPV are independent correlates of no reflow and in-hospital MACEs among patients with STEMI undergoing pPCI.
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Affiliation(s)
- Turgay Celik
- Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Mehmet G. Kaya
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mahmut Akpek
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Ozgur Gunebakmaz
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Bahadir Sarli
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mustafa Duran
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Sait Demirkol
- Department of Cardiology, Gulhane Military Medical Academy, Ankara, Turkey
| | - Onur Kadir Uysal
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Abdurrahman Oguzhan
- Department of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey
| | - C. Michael Gibson
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Karabacak M, Dogan A, Turkdogan AK, Kapci M, Duman A, Akpinar O. Mean platelet volume is increased in patients with hypertensive crises. Platelets 2013; 25:423-6. [DOI: 10.3109/09537104.2013.830181] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Cooke J, Murphy T, McFadden E, O'Reilly M, Cahill MR. Can mean platelet component be used as an index of platelet activity in stable coronary artery disease? Hematology 2013; 14:111-4. [DOI: 10.1179/102453309x385160] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- John Cooke
- Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland
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Platelet distribution width and the risk of periprocedural myocardial infarction in patients undergoing percutaneous coronary intervention. J Thromb Thrombolysis 2013; 37:345-52. [DOI: 10.1007/s11239-013-0954-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer's disease. J Psychiatr Res 2013; 47:644-9. [PMID: 23395109 DOI: 10.1016/j.jpsychires.2013.01.014] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Revised: 11/29/2012] [Accepted: 01/14/2013] [Indexed: 11/21/2022]
Abstract
Neuroinflammation is a critical driving force underlying mild cognitive impairment (MCI) and Alzheimer's disease (AD) pathologies. Activated platelets play an important role in neuroinflammation and have been implicated in AD pathogenic mechanisms. Mean platelet volume (MPV), a marker of platelet activation, is involved in the pathophysiology of a variety of pro-inflammatory diseases. However, little research has been conducted to investigate the relationship between platelet indices and MCI and AD pathogenesis. In this cross-sectional study, we investigated the levels of platelet count, MPV and platelet distribution width (PDW) in 120 AD patients, 120 MCI patients, and 120 non-demented controls. Our study showed that MPV and PDW were significantly lower in patients with AD as compared with either MCI or controls. Moreover, MCI patients had lower MPV and PDW values compared with the controls (P < 0.001). In addition, there is a positive correlation between mini-mental state examination (MMSE) and MPV and PDW, after adjusting age, gender, and body mass index (r = 0.576, P < 0.001 for MPV; r = 0.465, P < 0.001 for PDW, respectively). Multivariate analysis showed that MPV and PDW were significantly associated with MMSE (β = 0.462; P < 0.001 for MPV; β = 0.245; P < 0.001 for PDW; respectively). In conclusion, MPV and PDW were decreased in MCI and AD patients. Further prospective research is warranted to determine the potential clinical application of MPV and PDW as biomarkers in the early diagnosis of AD.
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Koudouovoh-Tripp P, Sperner-Unterweger B. Influence of mental stress on platelet bioactivity. World J Psychiatry 2012; 2:134-47. [PMID: 24175179 PMCID: PMC3782187 DOI: 10.5498/wjp.v2.i6.134] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2011] [Revised: 10/10/2012] [Accepted: 10/23/2012] [Indexed: 02/05/2023] Open
Abstract
It is well established that various mental stress conditions contribute, or at least influence, underlying pathophysiological mechanisms in somatic, as well as in psychiatric disorders; blood platelets are supposed to represent a possible link in this respect. The anculeated platelets are the smallest corpuscular elements circulating in the human blood. They display different serotonergic markers which seem to reflect the central nervous serotonin metabolism. They are known as main effectors in haematological processes but recent research highlights their role in the innate and adaptive immune system. Platelets are containing a multitude of pro-inflammatory and immune-modulatory bioactive compounds in their granules and are expressing immune-competent surface markers. Research gives hint that platelets activation and reactivity is increased by mental stress. This leads to enhanced cross talk with the immune system via paracrine secretion, receptor interaction and formation of platelet leucocyte-aggregates. Recently it has been demonstrated that the immune system can have a remarkable impact in the development of psychiatric disorders. Therefore platelets represent an interesting research area in psychiatry and their role as a possible biomarker has been investigated. We review the influence of mental stress on what is termed platelet bioactivity in this article, which subsumes the mainly immune-modulatory activity of platelets in healthy volunteers, elderly persons with chronic care-giving strain, patients with cardiovascular diseases who are prone to psychosocial stress, as well as in patients with posttraumatic stress disorder. Research data suggest that stress enhances platelet activity, reactivity and immune-modulatory capacities.
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Affiliation(s)
- Pia Koudouovoh-Tripp
- Pia Koudouovoh-Tripp, Clinic for Biological Psychiatry, Department of Psychiatry and Psychotherapy, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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Abstract
Platelet size correlates with platelet activity and can be assessed by platelet volume indices (PVI). The PVI, mean platelet volume (MPV), is universally available with routine blood counts by automated hemograms and therefore is an attractive index to study in clinical scenarios. PVI are useful in assessing the etiology of thrombocytopenia. In addition, a normal platelet distribution width in the setting of thrombocytosis is highly suggestive of a reactive etiology. Higher MPV is also associated with the presence of cardiovascular risk factors, chest pain due to acute coronary syndrome, and adverse outcome after acute coronary syndrome. Results from studies evaluating MPV in patients with peripheral artery disease, unprovoked deep vein thrombosis, and pulmonary embolism further advocate a potential role for MPV in identifying patients at high risk of thrombosis. Nevertheless, most of these data come from retrospective studies some of which have small study populations and confounding factors influencing platelet volume. Moreover, the cut-off values derived from these retrospective studies have not been validated prospectively. Despite the potential for clinical utility evident from these studies, the above-mentioned flaws together with technical problems in measuring MPV currently limit its clinical usefulness. Our review provides a perspective on PVI's potential clinical use.
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Affiliation(s)
- Avi Leader
- Department of Internal Medicine A, Meir Medical Center, Kfar Saba, Israel
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Bauer NB, Er E, Moritz A. Effect of submaximal aerobic exercise on platelet function, platelet activation, and secondary and tertiary hemostasis in dogs. Am J Vet Res 2012; 73:125-33. [DOI: 10.2460/ajvr.73.1.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ntaios G, Gurer O, Faouzi M, Aubert C, Michel P. Hypertension is an independent predictor of mean platelet volume in patients with acute ischaemic stroke. Intern Med J 2011; 41:691-5. [DOI: 10.1111/j.1445-5994.2009.02162.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Diaz-Ricart M, Brunso L, Pino M, Navalon F, Jou JM, Heras M, White JG, Escolar G. Preanalytical treatment of EDTA-anticoagulated blood to ensure stabilization of the mean platelet volume and component measured with the ADVIA counters. Thromb Res 2010; 126:e30-5. [PMID: 20427079 DOI: 10.1016/j.thromres.2010.04.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 04/06/2010] [Accepted: 04/06/2010] [Indexed: 10/19/2022]
Abstract
The mean platelet component (MPC) parameter calculated by the ADVIA blood cell analyzers provides direct information on density, or granularity, of platelets and could become a useful biomarker to detect in vivo platelet activation. Unfortunately, it is largely affected by time and storage conditions in standard anticoagulants based on EDTA. The present study was designed to improve the stability of the MPC in blood specimens to facilitate a more standardized use in different laboratories. Blood from healthy controls was collected into EDTA plus additives, and stored at different conditions. MPC and the mean platelet volume (MPV) were assessed at 30 min and at 1, 3, 6 and 24hours after blood drawing on the ADVIA 2120 system. Flow cytometry was used to evaluate platelet-activation proteins. Ultrastructural morphology of platelets was assessed using electron microscopy. Storage in EDTA increased MPV, decreased MPC, reduced the number of alpha-granules, and induced changes in the phosphorylation patterns of platelet proteins. A solution based on EDTA containing wortmanin and tyrphostin (ED-WORTY), both inhibitors of signaling pathways, provided good stability for most of the parameters tested up to 6 hours at room temperature. Storage at lower temperatures produced more favorable results. ED-WORTY solutions preserved adequate morphology and had minimal influence on other parameters provided by the ADVIA 2120 system. Thus, the additives included in ED-WORTY may be useful for maintaining the stability of MPC for prolonged periods and to facilitate the transport and exchange of samples among institutions and laboratories.
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Affiliation(s)
- Maribel Diaz-Ricart
- Servicio de Hemoterapia-Hemostasia, Centre de Diagnòstic Biomèdic, Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona 08036, Spain
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Bauer NB, Eralp O, Moritz A. Effect of hemolysis on canine kaolin-activated thromboelastography values and ADVIA 2120 platelet activation indices. Vet Clin Pathol 2010; 39:180-9. [DOI: 10.1111/j.1939-165x.2010.00224.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 2010; 30:1125-9. [DOI: 10.1007/s00296-009-1345-1] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Accepted: 12/29/2009] [Indexed: 01/26/2023]
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Bakovic D, Pivac N, Eterovic D, Palada I, Valic Z, Paukovic-Sekulic B, Dujic Z. CHANGES IN PLATELET SIZE AND SPLEEN VOLUME IN RESPONSE TO SELECTIVE AND NON-SELECTIVE β-ADRENOCEPTOR BLOCKADE IN HYPERTENSIVE PATIENTS. Clin Exp Pharmacol Physiol 2009; 36:441-6. [DOI: 10.1111/j.1440-1681.2008.05090.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lim YA, Cho SR. Effect of Platelet Transfusion on the Platelet Parameters of Recipient. THE KOREAN JOURNAL OF HEMATOLOGY 2009. [DOI: 10.5045/kjh.2009.44.1.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Young Ae Lim
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Sung Ran Cho
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
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Alsweedan SA, Al-Shurman A, Mahmoud AS. Diagnostic value of platelet indices in children with leukemia. J Pediatr Hematol Oncol 2008; 30:953-5. [PMID: 19131790 DOI: 10.1097/mph.0b013e318182e7a9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to investigate whether platelet indices [mean platelet volume (MPV) and platelet distribution width (PDW)] could serve as diagnostic tools for screening or as surrogate marker for follow-up in children with leukemia. Blood samples were obtained from 47 patients with leukemia at diagnosis before chemotherapy (mean age: 67 mo; 30 males and 17 females) and from 47 healthy controls (mean age: 59 mo; 27 males and 20 females). We measured the blood platelet indices using an automated counter. MPV was higher in the leukemia group, but it was not statistically significant. However, PDW was significantly lower (P<0.001) in leukemia group. There was no significant difference in the MPV or PDW in patients with acute lymphoblastic leukemia versus acute myeloblastic leukemia. In conclusion, we found no significant difference in the MPV between the 2 groups. PDW proposed as indicators of certain pathologic conditions and it seems possible to use PDW as screening. However, platelet indices (MPV and PDW) cannot be used as indicator to discriminate between the subtypes of leukemia in children. The potential role of platelet indices in leukemia remains to be investigated by a multi-institutional level to verify the possible clinical significance of this finding.
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Affiliation(s)
- Suleimman A Alsweedan
- Department of Pediatrics, Jordan University of Science and Technology, Irbid, Jordan.
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Ravindran R, Krishnan LK. Increased platelet cholesterol and decreased percentage volume of platelets as a secondary risk factor for coronary artery disease. PATHOPHYSIOLOGY OF HAEMOSTASIS AND THROMBOSIS 2008; 36:45-51. [PMID: 18332614 DOI: 10.1159/000112639] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 12/04/2007] [Indexed: 11/19/2022]
Abstract
Platelet hyperactivity is likely to contribute to the progression of atherogenesis and organized thrombus formation on vascular surfaces. The purpose of this study was to examine the effect of hypercholesterolemia on the cholesterol content of platelets, on platelet responsiveness and other platelet indices using platelets from 5 groups of age-matched subjects (n = 30 each), which includes healthy controls. All groups except controls had a high plasma lipid profile. While subjects in group I had only hyperlipidemia, those in groups II and III had hyperlipidemia in conjunction with diabetes mellitus and hypertension, respectively. The fourth group consisted of patients with confirmed coronary artery disease (CAD). The parameters studied include packed cell volume of platelets (platelet crit), platelet distribution width (PDW), platelet cholesterol and platelet aggregation in response to adenosine diphosphate and collagen. All the patient groups showed increased platelet aggregation (p < 0.05) and low platelet crit compared with controls (p < 0.05). In addition, platelet cholesterol was increased in patients with coronary disease, hyperlipidemia and diabetes mellitus (p < 0.05) but not in patients with hypertension (p > 0.05); PDW was high only in CAD (p < 0.05). A higher PDW indicated a prothrombotic tendency in CAD patients. Our data suggest that hyperlipidemia increases the lipid content in platelets and enhances their reactivity. Hyperactive platelets with increased platelet cholesterol may contribute to accelerated atherogenesis associated with CAD.
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Affiliation(s)
- Resmi Ravindran
- Thrombosis Research Unit, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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Boos CJ, Balakrishnan B, Lip GYH. The effects of coronary artery disease severity on time-dependent changes in platelet activation indices in stored whole blood. J Thromb Thrombolysis 2007; 25:135-40. [PMID: 17574521 DOI: 10.1007/s11239-007-0034-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Accepted: 04/04/2007] [Indexed: 01/26/2023]
Abstract
BACKGROUND Platelets play a pivotal role in the pathogenesis of the thrombotic complications in cardiovascular disease (CVD). Abnormal platelet activation indices are evolving as potentially useful markers in CVD risk stratification. Whilst there has been some investigation into the effects of storage time on several of these indices, the effects of underlying disease severity on these temporal changes have not been previously studied. METHODS Using the ADVIA 120 haematology analyser, we assessed the effects of time-dependent storage of whole blood in EDTA, on a number of platelet activation indices: mean platelet volume (MPV), mean platelet component (MPC, measure of platelet density) and platelet component distribution width (PCDW, a marker of platelet shape change. We studied three age- and sex-matched patient groups: (i) healthy controls (n = 10), (ii) stable patients with coronary artery disease (CAD, n = 9); and (iii) patients with acute myocardial infarction (n = 8). Whole blood samples were processed at exactly 5 min following venesection and at 15, 30, 60 and 120 min later in storage in EDTA tubes at room temperature. RESULTS There was a significant and stepwise increase in MPV (P = 0.01) and decrease in PCDW (P = 0.03), with a non-significant trend to increasing MPM and decreasing MPC with increasing underlying disease (that is healthy, 'stable' and 'acute' artery disease). There was a significant time-dependent increase in MPV and decrease in MPC and PCDW (all P < 0.05), which were all significant on 'post-hoc' analyses by 30 min. There were no significant changes in platelet count or MPM with time. There was no interaction of underlying disease with whole-blood storage time for any of the platelet indices reported (P = NS). CONCLUSION There is a temporal increase in MPV and decrease in MPC and PCDW in venous blood stored over 2 h in EDTA. These changes are not influenced by the underlying CVD disease severity.
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Affiliation(s)
- Christopher J Boos
- Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, B18 7QH, UK
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Koliakos G, Alamdari D, Tsagias N, Kouzi-Koliakos K, Michaloudi E, Karagiannis V. A novel high-yield volume-reduction method for the cryopreservation of UC blood units. Cytotherapy 2007; 9:654-9. [DOI: 10.1080/14653240701508445] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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