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Shi J, Shao MJ, Yu M, Tang BP. The Inflammation-Fibrosis Combined Index: A Novel Marker for Predicting Left Ventricular Reverse Remodeling and Prognosis in Patients with HFrEF. J Inflamm Res 2024; 17:3967-3982. [PMID: 38915807 PMCID: PMC11194169 DOI: 10.2147/jir.s460641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
Background Inflammation and cardiac fibrosis are important pathogenic drivers of heart failure. The fibrosis-4 index (FIB-4) is associated with a higher degree of fibrosis. The systemic immune inflammation index (SII) is associated with a higher degree of systemic inflammation status. Previous studies have shown that they are associated with a poor prognosis for cardiovascular disease. We sought to investigate the value of FIB-4 combined with the SII as a novel inflammation-fibrosis combined index (IFCI) in predicting left ventricular reverse remodeling (LVRR) and prognosis among reduced ejection fraction heart failure (HFrEF) patients. Methods A total of 895 patients with HFrEF were continuously recruited. Receiver operating characteristic curves were drawn to assess the abilities of inflammation-fibrosis indicators to predict LVRR. Multivariable Cox regression analysis was used to examine independent predictors of composite cardiac events and all-cause death. Results After six months of follow-up, 344 (38.4%) patients experienced LVRR. The IFCI had the largest area under the curve (0.835, P < 0.001). In multivariate-adjusted logistic regression analyses, FIB-4, SII, and IFCI were predictive of LVRR (P value < 0.05). The IFCI was associated with a 3.686-fold higher risk of non-LVRR (odds ratio [OR] = 3.686, P < 0.001). Moreover, an increased IFCI predicted a poor prognosis in HFrEF patients. The highest risk of composite cardiac events (hazard ratio [HR] = 2.716, P < 0.001) was observed in the top IFCI-tertile group, and similar results were found regarding independent risk indicators of all-cause death. Conclusion In summary, this study indicated that increased IFCI at admission offers good predictability regarding non-LVRR and predicts the risk of all-cause mortality or composite cardiovascular events due to HFrEF patients and could be used as a novel marker.
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Affiliation(s)
- Jia Shi
- Cardiac Pacing and Physiological Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Meng-Jiao Shao
- Department of Cardiology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, People’s Republic of China
| | - Miao Yu
- Cardiac Pacing and Physiological Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Bao-Peng Tang
- Cardiac Pacing and Physiological Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Cardiac Electrophysiology and Cardiac Remodeling, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
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Péč MJ, Jurica J, Péčová M, Benko J, Sokol J, Bolek T, Samec M, Hurtová T, Galajda P, Samoš M, Mokáň M. Role of Platelets in Rheumatic Chronic Autoimmune Inflammatory Diseases. Semin Thromb Hemost 2024; 50:609-619. [PMID: 38016649 DOI: 10.1055/s-0043-1777071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
Platelets are essential in maintaining blood homeostasis and regulating several inflammatory processes. They constantly interact with immune cells, have immunoregulatory functions, and can affect, through immunologically active substances, endothelium, leukocytes, and other immune response components. In reverse, inflammatory and immune processes can activate platelets, which might be significant in autoimmune disease progression and arising complications. Thus, considering this interplay, targeting platelet activity may represent a new approach to treatment of autoimmune diseases. This review aims to highlight the role of platelets in the pathogenic mechanisms of the most frequent chronic autoimmune inflammatory diseases to identify gaps in current knowledge and to provide potential new targets for medical interventions.
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Affiliation(s)
- Martin Jozef Péč
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Jakub Jurica
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Monika Péčová
- Oncology Centre, Teaching Hospital Martin, Martin, Slovak Republic
- Department of Hematology and Transfusiology, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Jakub Benko
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
- Department of Cardiology, Teaching Hospital Nitra, Nitra, Slovak Republic
| | - Juraj Sokol
- Department of Hematology and Transfusiology, National Centre of Hemostasis and Thrombosis, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Tomáš Bolek
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Marek Samec
- Department of Medical Biology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Tatiana Hurtová
- Department of Dermatovenerology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
- Department of Infectology and Travel Medicine, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Peter Galajda
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
| | - Matej Samoš
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
- Division of Acute and Interventional Cardiology, Department of Cardiology and Angiology II, Mid-Slovakian Institute of Heart and Vessel Diseases (SÚSCCH, a.s.), Banská Bystrica, Slovak Republic
| | - Marián Mokáň
- Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic
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Nejatifar F, Mirbolouk N, Masooleh IS, Kazemnejad E, Ghavidel-Parsa B, Ghanbari AM, Zayeni H. Association between neutrophil/lymphocyte ratio and disease severity in scleroderma patients. Heliyon 2023; 9:e20576. [PMID: 37860553 PMCID: PMC10582306 DOI: 10.1016/j.heliyon.2023.e20576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Systemic sclerosis is a chronic and progressive connective tissue disease with various manifestation. Inflammatory status is developed in early stages and is followed by major organs' dysfunction. Disease severity is evaluated mostly through Medsger scale. There is not any single laboratory test to evaluate disease severity, although some hematologic can reflect disease severity. In this study, we evaluated the association between hematologic indices (specially Neutrophil/Lymphocyte ratio) and Medsger score of disease severity. Materials and methods One hundred and twenty-three patients along with the same number of healthy controls were enrolled in this study. Demographic information and past medical records were gathered in first appointment. Hematologic indices were calculated based on the laboratory findings and the association between these indices and Medsger score of disease severity was evaluated. Results One hundred and twenty-three patients with mean disease duration of 9.54 and mean Medsger score of 7.42 were investigated in this study. Neutrophil count, erythrocyte sedimentation rate, red cell distribution width and NLR were significantly higher and mean platelets volume was significantly lower in SSc patients in comparison to controls. NLR was significantly correlated with pulmonary and cardiac involvements and Monocyte/Lymphocyte ratio was significantly correlated with the involvement of joint and tendons. We showed that NLR is a predictive factor for the severity of systemic sclerosis. We also found a cut off Value of 1.9 for NLR as a predictor for disease severity in our patients. Conclusion Our study shows that SSc and its severity is associated with some hematologic indices like NLR, MLR, platelets and hemoglobin. These indices can also specifically predict the involvement of some organs.
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Affiliation(s)
- Fatemeh Nejatifar
- Hematology and Medical Oncology Department, Guilan University of Medical Sciences, Rasht, Iran
| | - Neda Mirbolouk
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Irandokht Shenavar Masooleh
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad
- Guilan Trauma Research Center, Department of Biostatistics and Epidemiology, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Banafsheh Ghavidel-Parsa
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Mohammad Ghanbari
- Student Research Committee, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Habib Zayeni
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Wang Z, Qin Z, Yuan R, Guo J, Xu S, Lv Y, Xu Y, Lu Y, Gao J, Yu F, Tang L, Zhang L, Bai J, Cui X, Zhang J, Tang J. Systemic immune-inflammation index as a prognostic marker for advanced chronic heart failure with renal dysfunction. ESC Heart Fail 2022; 10:478-491. [PMID: 36316302 PMCID: PMC9871671 DOI: 10.1002/ehf2.14217] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 01/27/2023] Open
Abstract
AIMS We aim to investigate the correlation between high levels of the systemic immune-inflammation index (SII) and long-term mortality and major cardiovascular adverse events in advanced chronic heart failure patients with renal dysfunction. METHODS AND RESULTS Seven hundred seventeen advanced chronic heart failure patients with renal dysfunction, who visited the First affiliated hospital of Zhengzhou University from September 2019 to December 2020, were included. All-cause mortalities (ACM) were selected as primary endpoints and major cardiovascular adverse events (MACEs) as the secondary endpoints. Based on the receiver operating characteristic (ROC) curve and the Youden index, the optimal cut-off values of SII for ACM and MACEs were 1228 and 1406. In the group where ACM were the primary endpoint, patients were categorized into the low-SII group (n = 479) and the high-SII group (n = 238). Patients in the group using MACEs as the secondary endpoint were also categorized into the low-SII groups (n = 514) and the high-SII groups (n = 203). Univariate and multivariate COX regression were used to screen the independent predictors for ACM and MACEs, revealing the relationship between SII levels and endpoints. According to the univariate COX analysis, SII was the risk factor (hazard ratio [HR] = 2.144, 95% confidence interval [CI]: 1.565-2.938, P < 0.001) for the ACM subgroup. It was also the risk factor (HR = 1.625, CI: 1.261-2.905, P < 0.001) for the MACEs subgroup. Multivariate COX regression analysis indicated that the occurrence of ACM and MACEs in high-level SII and low-level SII patients had statistical differences. The incidence of ACM increased by 70.3% (HR = 1.703; 95% CI: 1.200-2.337; P = 0.002) in patients of the high SII level group, the incidence of MACEs increased by 58.3% (HR = 1.583, 95% CI: 1.213-2.065, P = 0.001). Kaplan-Meier (K-M) survival analysis further suggested that patients with a high SII level had an increased risk of having ACM (log-rank P < 0.001) and MACEs (log-rank P < 0.001) within 30 months. SII could be considered as a novel predictor of the occurrence of ACM and MACEs for patients with advanced chronic heart failure and renal dysfunction. CONCLUSIONS This study suggested that SII is a novel independent predictor of mortality in advanced chronic heart failure patients with renal dysfunction, and it should be considered in current clinical management.
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Affiliation(s)
- Zeyu Wang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Zhen Qin
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Ruixia Yuan
- Clinical Big Data CenterThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina
| | - Jiacheng Guo
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Shuai Xu
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Yan Lv
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Yanyan Xu
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Yongzheng Lu
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Jiamin Gao
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Fengyi Yu
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Laiyi Tang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Li Zhang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Jing Bai
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Xiaolin Cui
- School of MedicineThe Chinese University of Hong KongShenzhenChina
| | - Jinying Zhang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
| | - Junnan Tang
- Department of CardiologyThe First Affiliated Hospital of Zhengzhou UniversityZhengzhouChina,Henan Province Key Laboratory of Cardiac Injury and RepairZhengzhouChina,Henan Province Clinical Research Center for Cardiovascular DiseasesZhengzhouChina
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Wu H, Zhou H, Chen P. Correlation of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) with gout activity: A monocentric and retrospective study. Medicine (Baltimore) 2022; 101:e30242. [PMID: 36107534 PMCID: PMC9439824 DOI: 10.1097/md.0000000000030242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
To evaluate the correlation of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and mean platelet volume (MPV) with parameters related to gout activity. The general data of the patients and healthy controls (HCs), including complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum uric acid (SUA), and the presence of tophi were retrospectively analyzed. NLR, MPV, and PLR were calculated in patients with intercritical gout and gout flares. Correlation of the 3 markers with clinical features, like ESR, CRP, SUA, and the presence of tophi, were analyzed. The results revealed that NLR and PLR were elevated and MPV was markedly decreased in patients with gout compared with HCs (all P < .05). In patients with gout flares, NLR, and PLR were higher and MPV was lower than in intercritical gout patients (all P < .05). NLR and PLR were positively correlated with ESR and CRP, whereas MPV was negatively correlated with ESR. NLR, PLR, and MPV showed no obvious correlation with SUA and the presence of tophi. The receiver operating characteristic curve showed that NLR was more valuable in assessing gout disease activity. NLR, PLR, and MPV were correlated with inflammatory parameters in gout; they may be used as complementary tools to evaluate gout activity.
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Affiliation(s)
- Haihua Wu
- Department of Rheumatology, Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou, China
- *Correspondence: Haihua Wu or Panfeng Chen, Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, China (e-mail: ; )
| | - Hui Zhou
- Department of Rheumatology, Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou, China
| | - Panfeng Chen
- Department of Rheumatology, Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou, China
- *Correspondence: Haihua Wu or Panfeng Chen, Xiaoshan District Traditional Chinese Medicine Hospital, Hangzhou 311200, China (e-mail: ; )
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Abstract
Pulmonary pressure is one of the most important parameters in the postoperative follow-up of patients who have undergone the Glenn procedure. Platelet activation markers, which are inexpensive and easily accessible blood count parameters, have been shown to be associated with the aetiology and pathogenesis of primary pulmonary artery hypertension. We examined the relationship between platelet activation markers and pulmonary pressures in the early postoperative period of patients who underwent the Glenn procedure.Eighty-five patients who underwent the Glenn procedure in our clinic between January 2011 and March 2020 were included in the study retrospectively. Fifty-one patients were male and 34 were female, and age varied from 4 to 416 months, with a mean of 28.64 ± 51 months.Patients with increased pulmonary blood flow on palliation before Glenn surgery had higher mean platelet volume values. However, no correlation was found between pulmonary pressures and platelet activation markers in the early postoperative period.There was not similar study evaluating platelet activation markers in the paediatric age group before and after postoperative Glenn surgery in the literature. Therefore, even if platelet activation markers provide information about the pulmonary bed, they may be misleading due to other reasons that trigger bleeding and inflammatory processes in the early postoperative period.
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Oyama T, Kinoshita H, Takekawa D, Saito J, Kushikata T, Hirota K. Higher neutrophil-to-lymphocyte ratio, mean platelet volume, and platelet distribution width are associated with postoperative delirium in patients undergoing esophagectomy: a retrospective observational study. J Anesth 2021; 36:58-67. [PMID: 34595569 DOI: 10.1007/s00540-021-03007-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/24/2021] [Indexed: 12/18/2022]
Abstract
PURPOSE We investigated whether preoperative inflammatory markers, i.e., the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) can predict the development of postoperative delirium (POD) after esophagectomy. PATIENTS AND METHODS This single-center, retrospective, observational study included 110 patients who underwent an esophagectomy. We assigned the patients with the Intensive Care Delirium Screening Checklist score ≥ 4 to the POD group. We performed multivariable logistic regression analyses to determine whether the NLR, PLR, MPV, and PDW can be used to predict the development of POD. RESULTS The POD group had 20 patients; the non-POD group included the other 90 patients. Although only the preoperative NLR in the POD group was significantly higher than in the non-POD group (3.20 [2.52-4.30] vs. 2.05 [1.45-3.02], p = 0.001), multivariable logistic regression analyses showed that the following three parameters were independent predictors of POD: preoperative NLR ≥ 2.45 (adjusted odds ratio [aOR]: 8.68, 95%CI 2.33-32.4, p = 0.001), MPV ≥ 10.4 (aOR: 3.93, 95%CI: 1.37-11.2, p = 0.011), and PDW ≥ 11.8 (aOR: 3.58, 95%CI: 1.22-10.5, p = 0.020). CONCLUSION Our analysis results demonstrated that preoperative NLR ≥ 2.45, MPV ≥ 10.4, and PDW ≥ 11.8 were significantly associated with a higher risk of POD after adjustment for possible confounding factors. However, as the AUCs of the preoperative MPV and PDW for the prediction of the development of POD in univariable ROC analyses were low, large prospective studies are needed to confirm this result.
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Affiliation(s)
- Tasuku Oyama
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Hirotaka Kinoshita
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Daiki Takekawa
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
| | - Junichi Saito
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Tetsuya Kushikata
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Kazuyoshi Hirota
- Department of Anesthesiology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
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He Y, Yu Y, Hu S. Platelet Distribution Width Level in Patients With Systemic Lupus Erythematosus-Associated Pulmonary Arterial Hypertension and Its Diagnostic Value. Arch Rheumatol 2021; 35:394-400. [PMID: 33458663 PMCID: PMC7788649 DOI: 10.46497/archrheumatol.2020.7791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 11/10/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives
This study aims to compare the platelet distribution width (PDW) level in patients with systemic lupus erythematosus-associated pulmonary arterial hypertension (SLE-PAH) with that in patients with systemic lupus erythematosus alone (SLE-non-PAH) and to evaluate the clinical value of the PDW level in the early diagnosis of SLE-PAH. Patients and methods
We analyzed 80 SLE-PAH patients (1 males, 79 females; 34.9±12.3 years; range, 19 to 77 years) and 154 sex- and age-matched SLE-non-PAH patients (4 males, 150 females; mean age 36.7±12.4 years; range, 19 to 69 years) hospitalized between June 2011 and April 2018. All patients underwent transthoracic Doppler echocardiography within three months of inclusion in the study. Age, sex, disease course, currently prescribed medications, clinical manifestations, and past history were collected. Pulmonary artery systolic pressure, ejection fraction, white blood cell count, red blood cell count, hemoglobin, platelet count, PDW, mean platelet volume, erythrocyte sedimentation rate, complement 3 (C3), and C4 levels were also obtained. Results
The PDW level was higher in the SLE-PAH group than that in the SLE-non-PAH group (p=0.023). SLE patients were allocated into high systemic lupus erythematosus disease activity index (SLEDAI) group (SLEDAI score, ≥10) (n=121) or low SLEDAI group (SLEDAI score, <10) (n=113). The PDW level was significantly higher in the high SLEDAI group than that in the low SLEDAI group (p=0.030). The receiver operating characteristic curve was used to evaluate the clinical value of the PDW level in diagnosing PAH in SLE patients. The PDW level was valuable for diagnosing PAH in SLE patients [area under the curve (AUC)=0.591, p=0.023]. The optimal critical value of the PDW level was 14.55 fL. Under these conditions, the sensitivity, specificity, and Youden index were 57%, 63% and 0.20, respectively. For newly diagnosed patients, the PDW level had good diagnostic accuracy, with an AUC of 0.626 (p=0.037). The optimal critical value of the PDW level was 14.65 fL. Under these conditions, the sensitivity, specificity, and Youden index were 66%, 67% and 0.33, respectively. Conclusion The PDW level is a good predictor of SLE-PAH, and this parameter is applicable to various clinical settings.
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Affiliation(s)
- Yuzhu He
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yikai Yu
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shaoxian Hu
- Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Sato Y, Yoshihisa A, Watanabe K, Hotsuki Y, Kimishima Y, Yokokawa T, Misaka T, Sato T, Kaneshiro T, Oikawa M, Kobayashi A, Takeishi Y. Association between platelet distribution width and prognosis in patients with heart failure. PLoS One 2020; 15:e0244608. [PMID: 33373413 PMCID: PMC7771660 DOI: 10.1371/journal.pone.0244608] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/11/2020] [Indexed: 11/18/2022] Open
Abstract
Background The prognostic impact of platelet distribution width (PDW), which is a specific marker of platelet activation, has been unclear in patients with heart failure (HF). Methods and results We conducted a prospective observational study enrolling 1,746 hospitalized patients with HF. Patients were divided into tertiles based on levels of PDW: 1st (PDW < 15.9 fL, n = 586), 2nd (PDW 15.9–16.8 fL, n = 617), and 3rd (PDW ≥ 16.9, n = 543) tertiles. We compared baseline patients’ characteristics and post-discharge prognosis: all-cause death; cardiac death; and cardiac events. The 3rd tertile showed the highest age and levels of B-type natriuretic peptide compared to other tertiles (1st, 2nd, and 3rd tertiles; age, 69.0, 68.0, and 70.0 years old, P = 0.038; B-type natriuretic peptide, 235.2, 171.9, and 241.0 pg/mL, P < 0.001). Left ventricular ejection fraction was equivalent among the tertiles. In the Kaplan-Meier analysis, rates of all endpoints were the highest in the 3rd tertile (log-rank P < 0.001, respectively). The Cox proportional hazard analysis revealed that the 3rd tertile was associated with adverse prognosis (all-cause death, hazard ratio [HR] 1.716, P < 0.001; cardiac death, HR 1.919, P < 0.001; cardiac event, HR 1.401, P = 0.002). Conclusions High PDW is a novel predictor of adverse prognosis in patients with HF.
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Affiliation(s)
- Yu Sato
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akiomi Yoshihisa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan
- * E-mail:
| | - Koichiro Watanabe
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yu Hotsuki
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yusuke Kimishima
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tetsuro Yokokawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tomofumi Misaka
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
- Department of Advanced Cardiac Therapeutics, Fukushima Medical University, Fukushima, Japan
| | - Takamasa Sato
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Takashi Kaneshiro
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masayoshi Oikawa
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Kobayashi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
| | - Yasuchika Takeishi
- Department of Cardiovascular Medicine, Fukushima Medical University, Fukushima, Japan
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10
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Variation of red blood cell parameters in Behcet's disease: association with disease severity and vascular involvement. Clin Rheumatol 2020; 40:1457-1464. [PMID: 32939568 DOI: 10.1007/s10067-020-05397-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/18/2020] [Accepted: 09/12/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION/OBJECTIVES Behcet's disease (BD) is a systemic and chronic inflammatory vasculitis with unknown etiology. Diagnosis is determined by evaluating several clinical criteria, but the lack of specific laboratory diagnostic markers makes the diagnosis of BD more difficult. Therefore, the aim of this study was to determine the changes in hematological parameters in BD patients to investigate their relationship with BD clinical features. METHOD A total of 48 BD patients and 96 healthy controls were included in this study. The severity of each BD patient was associated to a severity score according to the entire spectrum of disease manifestations. Several laboratory tests were assessed, and the difference in their results between BD patients and healthy controls was evaluated. Correlation analysis was performed to reveal the interaction of these parameters. RESULTS C-reactive protein (CRP), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), neutrophil count, platelet count, and plateletcrit significantly increased in BD patients compared with healthy controls (P < 0.05). CRP was higher in patients with skin lesions, MCH and MCHC were lower in patients with vascular involvement, and the neutrophil count was higher in patients with skin lesions and genital ulcers. In addition, higher CRP and lower MCH and MCHC were associated with a severe condition. Besides, MCH and MCHC were negatively correlated with the platelet count, plateletcrit, and neutrophil count. CONCLUSIONS This study revealed that MCH and MCHC are valuable parameters for BD. Their levels help assess the disease severity and indicate the vascular involvement in BD. Key Points • This is the first study reporting MCH and MCHC as important biomarkers in BD. • BD patients with vascular involvement and thrombosis potential have lower levels of MCH and MCHC. • MCH and MCHC are negatively correlated with platelet count, plateletcrit, and neutrophil count. • Lower MCH and MCHC are associated with a severe condition.
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11
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Doskaliuk B, Zaiats L, Yatsyshyn R, Gerych P, Cherniuk N, Zimba O. Pulmonary involvement in systemic sclerosis: exploring cellular, genetic and epigenetic mechanisms. Rheumatol Int 2020; 40:1555-1569. [PMID: 32715342 DOI: 10.1007/s00296-020-04658-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/20/2020] [Indexed: 12/14/2022]
Abstract
Systemic sclerosis (SSc) is a chronic progressive autoimmune disease characterized by immune inflammation, vasculopathy, and fibrosis. There are still numerous uncertainties in the understanding of disease initiation and progression. Pulmonary involvement in SSc, and particularly pulmonary fibrosis, is critical for all organ systems affections in this disease. This review is aimed to describe and analyze new findings in the pathophysiology of SSc-associated pulmonary involvement and to explore perspective diagnostic and therapeutic strategies. A myriad of cellular interactions is explored in the dynamics of progressive interstitial lung disease (ILD) and pulmonary hypertension (PH) in SSc. The role of exosomes, microvesicles, and apoptotic bodies is examined and the impact of micro and long non-coding RNAs, DNA methylation, and histone modification in SSc is discussed.
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Affiliation(s)
- Bohdana Doskaliuk
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine. .,Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76000, Ukraine.
| | - Liubomyr Zaiats
- Department of Pathophysiology, Ivano-Frankivsk National Medical University, Halytska Str. 2, Ivano-Frankivsk, 76000, Ukraine
| | - Roman Yatsyshyn
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Petro Gerych
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Nataliia Cherniuk
- Academician Ye. M. Neiko Department of Internal Medicine #1, Clinical Immunology and Allergology, Ivano-Frankivsk National Medical University, Ivano-Frankivsk, Ukraine
| | - Olena Zimba
- Department of Internal Medicine #2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
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12
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Li B, Lu J, Peng DZ, Zhang XY, You Z. Elevated platelet distribution width predicts poor prognosis in hilar cholangiocarcinoma. Medicine (Baltimore) 2020; 99:e19400. [PMID: 32195935 PMCID: PMC7220385 DOI: 10.1097/md.0000000000019400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Although the platelet distribution width (PDW) has been reported as a reliable predictor of prognosis in several types of cancer, to our knowledge the prognostic value of PDW in hilar cholangiocarcinoma (HC) has not been studied. The aim of the study was to investigate the prognostic value of PDW in HC patients. A retrospective analysis of 292 consecutively recruited HC patients undergoing radical resection with at least a 5-year follow-up. The optimal cutoff value of PDW was determined by receiver operating characteristic (ROC) curve. Survival analysis by the Kaplan-Meier method and the difference between the clinico-pathologic variables and survival was evaluated by log-rank analysis. Multivariate analysis identified independent prognostic risk factors of overall survival (OS). ROC curve analysis suggested that the optimal cutoff value for the PDW was 16.55. There were significant associations of high PDW with high white blood cell (P < .001) and high neutril-to-lymph ratio (P < .001). In a multivariate analysis, the PDW was an independent prognostic factor for overall survival (HR = 2.521, 95% CI 1.832-3.470, P < .001). In conclusions, our findings indicate that PDW may have clinical significance in predicting OS after surgery in HC patients.
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Affiliation(s)
- Bei Li
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
- West China-Washington Mitochondria Metabolism Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Jiong Lu
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Ding-Zhong Peng
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Xin-Yi Zhang
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
| | - Zhen You
- Department of Biliary Surgery, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang
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13
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Tezcan D, Turan Ç, Yılmaz S, Sivrikaya A, Gülcemal S, Limon M, Ecer B. What do simple hematological parameters tell us in patients with systemic sclerosis? ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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14
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Kucuk H, Tecer D, Goker B, Varan O, Babaoglu H, Guven SC, Ozturk MA, Haznedaroglu S, Tufan A. Platelet/lymphocyte ratio and mean platelet volume in patients with granulomatosis with polyangiitis. Adv Rheumatol 2019; 60:4. [DOI: 10.1186/s42358-019-0110-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 12/23/2019] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background
Granulomatosis with polyangiitis (GPA) is a granulomatous necrotizing vasculitis with high morbidity and mortality. Anti-neutrophil cytoplasmic antibody is a valuable diagnostic marker, however its titer lacks predictive value for the severity of organ involvement. Platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) has been regarded as a potential marker in assessing systemic inflammation. We aimed to explore the value of PLR and MPV in the assessment of disease activity and manifestations of disease in GPA.
Methods
56 newly diagnosed GPA patients and 53 age-sex matched healthy controls were included in this retrospective and cross-sectional study with comparative group. Complete blood count was performed with Backman Coulter automatic analyzer, erythrocyte sedimentation rate (ESR) with Westergen method and C-reactive protein (CRP) levels with nephelometry. The PLR was calculated as the ratio of platelet and lymphocyte counts.
Result
Compared to control group, ESR, CRP and PLR were significantly higher and MPV significantly lower in GPA patients. In patients group, PLR was positively correlated with ESR and CRP (r = 0.39, p = 0.005 and r = 0.51, p < 0.001, respectively). MPV was negatively correlated with ESR and CRP (r = − 0.31, p = 0.028 and r = − 0.34 p = 0.014, respectively). Patients with renal involvement had significantly higher PLR than patients without renal involvement (median:265.98, IQR:208.79 vs median:180.34 IQR:129.37, p = 0.02). PLR was negatively correlated with glomerular filtration rate (r = − 0.27, p = 0.009). A cut-off level of 204 for PLR had 65.6% sensitivity and 62.5 specificity to predict renal involvement.
Conclusion
PLR exhibit favorable diagnostic performance in predicting renal involvement in patients with GPA.
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15
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Ramirez GA, Manfredi AA, Maugeri N. Misunderstandings Between Platelets and Neutrophils Build in Chronic Inflammation. Front Immunol 2019; 10:2491. [PMID: 31695699 PMCID: PMC6817594 DOI: 10.3389/fimmu.2019.02491] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
Regulated hemostasis, inflammation and innate immunity entail extensive interactions between platelets and neutrophils. Under physiological conditions, vascular inflammation offers a template for the establishment of effective intravascular immunity, with platelets providing neutrophils with an array of signals that increase their activation threshold, thus limiting collateral damage to tissues and promoting termination of the inflammatory response. By contrast, persistent systemic inflammation as observed in immune-mediated diseases, such as systemic vasculitides, systemic sclerosis, systemic lupus erythematosus or rheumatoid arthritis is characterized by platelet and neutrophil reciprocal activation, which ultimately culminates in the generation of thrombo-inflammatory lesions, fostering vascular injury and organ damage. Here, we discuss recent evidence regarding the multifaceted aspects of platelet-neutrophil interactions from bone marrow precursors to shed microparticles. Moreover, we analyse shared and disease-specific events due to an aberrant deployment of these interactions in human diseases. To restore communications between the pillars of the immune-hemostatic continuum constitutes a fascinating challenge for the near future.
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Affiliation(s)
- Giuseppe A Ramirez
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Angelo A Manfredi
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Norma Maugeri
- Vita-Salute San Raffaele University, Milan, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, Milan, Italy
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16
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Yayla ME, İlgen U, Okatan İE, UsluYurteri E, Torgutalp M, Keleşoğlu Dinçer AB, Aydemir Gülöksüz EG, Sezer S, Turgay TM, Kınıklı G, Ateş A. Association of simple hematological parameters with disease manifestations, activity, and severity in patients with systemic sclerosis. Clin Rheumatol 2019; 39:77-83. [PMID: 31317426 DOI: 10.1007/s10067-019-04685-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/16/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION/OBJECTIVES Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and red cell distribution width (RDW) may potentially reflect inflammatory status in systemic autoimmune diseases. The aim of this study is to investigate the association between these proposed markers and disease manifestations, activity, and severity in systemic sclerosis (SSc). METHOD We conducted a cross-sectional study of 69 systemic sclerosis (SSc) patients and 50 healthy volunteers in a single center. Adult patients with SSc and healthy controls were compared in terms of NLR, MLR, MPV, RDW, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Venous blood samples were drawn after at least 8 h of fasting in the morning. Extension of skin fibrosis was evaluated by using modified Rodnan skin score (mRSS). Disease severity and activity were assessed by Medsger disease severity and European Scleroderma Trials and Research Group (EUSTAR) disease activity scores, respectively. Associations of disease manifestations, clinical, laboratory, and capillaroscopic findings, mRSS, and the disease activity and severity scores with the proposed hematological markers were evaluated. Multiple regression models were generated for significant associations. RESULTS The neutrophil number was higher (p = 0.004) and lymphocyte number was lower (p < 0.001) in SSc group compared to controls. SSc group also had higher NLR, MLR, and RDW. In multiple logistic regression, only the NLR (regression coefficient = 3.49, p = 0.031) and CRP (regression coefficient = 0.17, p = 0.037) remained significantly different between SSc and healthy control groups (Cox and Snell R2 = 0.243, Nagelkerke R2 = 0.337, p < 0.001). NLR and MLR positively correlated with mRSS, EUSTAR score, and CRP. MLR also positively correlated with Medsger score. Higher monocyte counts independently predicted higher EUSTAR and Medsger scores in multiple linear regressions. Patients with digital ulcers had higher NLR and MLR. We did not find any difference in MPV values between SSc and healthy control groups. CONCLUSIONS Globally available and inexpensive hematological tests, particularly the NLR and MLR, may be associated with vascular and cutaneous manifestations as well as disease activity and severity in SSc.Key Points• Monocyte count itself independently predicted higher activity and severity scores in SSc.• Globally available and inexpensive hematological markers, particularly the NLR and MLR, may have an association with vascular and cutaneous manifestations as well as disease activity and severity in patients with SSc.
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Affiliation(s)
- Müçteba Enes Yayla
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey.
| | - Ufuk İlgen
- Department of Rheumatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - İlyas Ercan Okatan
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Emine UsluYurteri
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Murat Torgutalp
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | | | | | - Serdar Sezer
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Tahsin Murat Turgay
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Gülay Kınıklı
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Aşkın Ateş
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
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17
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Gökçen N, Coşkun Benlidayı İ, Başaran S. Diz osteoartritli hastalarda ortalama trombosit hacminin hastalık parametreleri ile ilişkisi. EGE TIP DERGISI 2019. [DOI: 10.19161/etd.416648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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18
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Silva-Rojas R, Treves S, Jacobs H, Kessler P, Messaddeq N, Laporte J, Böhm J. STIM1 over-activation generates a multi-systemic phenotype affecting the skeletal muscle, spleen, eye, skin, bones and immune system in mice. Hum Mol Genet 2018; 28:1579-1593. [DOI: 10.1093/hmg/ddy446] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Roberto Silva-Rojas
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
| | - Susan Treves
- Departments of Biomedicine and Anaesthesia, Basel University Hospital, Basel University, Basel, Switzerland
- Department of Life Sciences, General Pathology section, University of Ferrara, Ferrara, Italy
| | - Hugues Jacobs
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
- Institut Clinique de la Souris (ICS), Illkirch, France
| | - Pascal Kessler
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
| | - Nadia Messaddeq
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
| | - Jocelyn Laporte
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
| | - Johann Böhm
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm, CNRS, Université de Strasbourg, Illkirch, France
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19
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Moghadam RH, Shahmohammadi A, Asgari N, Azizi K, Mansour SM, Roozbahani M. Comparison of mean platelet volume levels in coronary artery ectasia and healthy people: systematic review and meta-analysis. Blood Res 2018; 53:269-275. [PMID: 30588462 PMCID: PMC6300668 DOI: 10.5045/br.2018.53.4.269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 12/16/2022] Open
Abstract
Coronary artery ectasia (CAE) is defined as the dilation of a segment of a coronary vessel to at least 1.5 times the diameter of its normal adjacent segment. Mean platelet volume (MPV) plays a role in acute coronary syndromes, with high MPV correlating to poor prognosis for acute thrombotic events and CAE. Several studies investigated the relationship between MPV and CAE, resulting in conflicting results. These results led us to systematically review all studies investigating the relationship between MPV and ectatic heart diseases by performing a meta-analysis study in order to report a unified result. This meta-analysis study investigated all case-control articles examining the relationship between MPV and CAE. All studies in the following databases published until January 31, 2018, were investigated: Science Direct, Scopus, PubMed, Google Scholar, and Web of Science. Following a quality control evaluation, 14 articles, all of which were published following studies performed in Turkey from 2007 to 2016, met the criteria for study inclusion. After pooling the results from all of the articles, a total standardized mean difference (SMD) value of 0.584 (95% CI, 0.219, 0.95) was obtained using the D+L pooled SMD, indicating a significant difference (P=0.002) between the two groups, with higher MPV values in ectatic patients when comparing to healthy individuals. Therefore, increased MPV levels were significantly related to CAE, suggesting that platelets, with their inflammatory and thrombotic activities, play a role in this disease. Therefore, anti-platelet and anti-inflammatory therapies may be effective in treating CAE.
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Affiliation(s)
- Reza Heidary Moghadam
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Afshar Shahmohammadi
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Asgari
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Koorosh Azizi
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Mehr Mansour
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Roozbahani
- Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
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20
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Soliman WM, Sherif NM, Ghanima IM, El-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: Relation with disease activity and lupus nephritis. ACTA ACUST UNITED AC 2018; 16:255-261. [PMID: 30166230 DOI: 10.1016/j.reuma.2018.07.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Revised: 07/20/2018] [Accepted: 07/24/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To investigate the role of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as activity markers in systemic lupus erythematosus (SLE) without nephritis and lupus nephritis (LN) patients. PATIENTS AND METHODS This study included 60 SLE patients with LN, 60 SLE patients without renal involvement and 30 healthy controls. We analyzed correlations between NLR and PLR and both disease activity and renal affection. RESULTS The NLR of SLE patients was much higher than those of the controls. Both ratios showed significantly increased values in SLE patients with active disease. NLR and PLR were positively correlated with SLEDAI, ESR, and CRP and negatively correlated with C4. SLE patients with LN had higher levels of NLR than those without nephritis. NLR showed positive correlations with BUN, serum urea, serum creatinine and 24h urinary protein. We found NLR to be related to anti-ds-DNA level and renal biopsy classes. While PLR was related only to anti ds-DNA. The best NLR to predict SLE active disease was 2.2 and the best PLR cut-off value was 132.9. CONCLUSION NLR and PLR are useful inflammatory markers to evaluate disease activity in SLE patients. Also, NLR could reflect renal involvement in SLE patients and is associated with the different classes of its histological staging.
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Affiliation(s)
- Wafaa M Soliman
- Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nahed M Sherif
- Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Iman M Ghanima
- Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohja A El-Badawy
- Department of Physical Medicine, Rheumatology and Rehabilitation, Ain Shams University Hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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21
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Scherlinger M, Guillotin V, Truchetet ME, Contin-Bordes C, Sisirak V, Duffau P, Lazaro E, Richez C, Blanco P. Systemic lupus erythematosus and systemic sclerosis: All roads lead to platelets. Autoimmun Rev 2018; 17:625-635. [PMID: 29635077 DOI: 10.1016/j.autrev.2018.01.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 01/18/2018] [Indexed: 01/13/2023]
Abstract
Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are two phenotypically distincts inflammatory systemic diseases. However, SLE and SSc share pathogenic features such as interferon signature, loss of tolerance against self-nuclear antigens and increased tissue damage such as fibrosis. Recently, platelets have emerged as a major actor in immunity including auto-immune diseases. Both SLE and SSc are characterized by strong platelet system activation, which is likely to be both the witness and culprit in their pathogenesis. Platelet activation pathways are multiple and sometimes redundant. They include immune complexes, Toll-like receptors activation, antiphospholipid antibodies and ischemia-reperfusion associated with Raynaud phenomenon. Once activated, platelet promote immune dysregulation by priming interferon production by immune cells, providing CD40L supporting B lymphocyte functions and providing a source of autoantigens. Platelets are actively implicated in SLE and SSc end-organ damage such as cardiovascular and renal disease and in the promotion of tissue fibrosis. Finally, after understanding the main pathogenic implications of platelet activation in both diseases, we discuss potential therapeutics targeting platelets.
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Affiliation(s)
- Marc Scherlinger
- Service de Rhumatologie, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Vivien Guillotin
- Service de médecine interne, FHU ACRONIM, Hôpital Saint André, Centre Hospitalier Universitaire, 1 rue Jean Burguet, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Marie-Elise Truchetet
- Service de Rhumatologie, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Cécile Contin-Bordes
- Laboratoire d'Immunologie et Immunogénétique, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Vanja Sisirak
- Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Pierre Duffau
- Service de médecine interne, FHU ACRONIM, Hôpital Saint André, Centre Hospitalier Universitaire, 1 rue Jean Burguet, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Estibaliz Lazaro
- Laboratoire d'Immunologie et Immunogénétique, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Christophe Richez
- Service de Rhumatologie, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Patrick Blanco
- Laboratoire d'Immunologie et Immunogénétique, FHU ACRONIM, Hôpital Pellegrin, Centre Hospitalier Universitaire, Place Amélie Raba Léon, 33076 Bordeaux, France; Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France; CNRS-UMR 5164, ImmunoConcept, Université de Bordeaux, 146 rue Léo Saignat, 33076 Bordeaux, France.
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Bahali AG, Su O, Emiroglu N, Cengiz FP, Kaya MO, Onsun N. Evaluation of mean platelet volume in localized scleroderma. An Bras Dermatol 2018; 92:635-637. [PMID: 29166498 PMCID: PMC5674694 DOI: 10.1590/abd1806-4841.20176045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 06/22/2016] [Indexed: 12/24/2022] Open
Abstract
Background Localized scleroderma is a chronic inflammatory skin disease characterized by
sclerosis of the dermis and subcutaneous tissue. Platelets play an important
role in inflammation. Following activation, platelets rapidly release
numerous mediators and cytokines, which contribute to inflammation. Objectives To evaluate whether there was any relation between localized scleroderma and
platelet parameters. Methods Forty-one patients with localized scleroderma were enrolled in the study. The
control group consisted of 30 healthy subjects. Results The mean platelet volume level in the patient group was 9.9 ± 1.3 fl
and in the control group was 7.6 ± 1.1 fl. This difference was
statistically significant (p< 0.001). The plateletcrit values are
minimally higher in the patient group as compared to the control group. It
was statistically significant (p<0.001). There was no significant
difference in the platelet counts between the two groups (p= 0.560) In the
patient group, there was no significant relation between the mean platelet
volume levels and clinical signs of disease (p=0.09). However, plateletcrit
values are higher in generalized than localized forms of disease
(p=0.01). Study Limitations The limited number of patients and the retrospective nature of the study were
our limitations. Conclusions This study suggests that platelets might play a role in the pathogenesis of
scleroderma. Platelet parameters may be used as markers for evaluating
disease severity and inflammatory processes. Thus, there is a need for more
detailed and prospective studies.
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Affiliation(s)
- Anil Gulsel Bahali
- Department of Dermatology, Bezmialem Vakıf University - Istanbul, Turkey
| | - Ozlem Su
- Department of Dermatology, Bezmialem Vakıf University - Istanbul, Turkey
| | - Nazan Emiroglu
- Department of Dermatology, Bezmialem Vakıf University - Istanbul, Turkey
| | - Fatma Pelin Cengiz
- Department of Dermatology, Bezmialem Vakıf University - Istanbul, Turkey
| | - Mehmet Onur Kaya
- Department of Biostatistics, Bezmialem Vakıf University - Istanbul, Turkey
| | - Nahide Onsun
- Department of Dermatology, Bezmialem Vakıf University - Istanbul, Turkey
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Fawzy RM, Said EA, Mansour AI. Association of neutrophil to lymphocyte ratio with disease activity indices and musculoskeletal ultrasound findings in recent onset rheumatoid arthritis patients. EGYPTIAN RHEUMATOLOGIST 2017. [DOI: 10.1016/j.ejr.2017.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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The Relationship between Hematological Indices and Autoimmune Rheumatic Diseases (ARDs), a Meta-Analysis. Sci Rep 2017; 7:10833. [PMID: 28883472 PMCID: PMC5589752 DOI: 10.1038/s41598-017-11398-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/23/2017] [Indexed: 01/03/2023] Open
Abstract
This meta-analysis was undertaken to investigate the relationship between hematological indices and autoimmune rheumatic diseases (ARDs). PubMed, Embase, and Web of Science were searchedfor studies of ARDs and hematological indices. Standardized mean difference (SMD) was calculated with confidence interval (CI) of 95%. 18 studies were included in our meta-analysis. Compared to the healthy control group, neutrophil–lymphocyte ratio (NLR) was increased in patients with ankylosing spongdylitis(AS), Behçet’s disease(BD), andrheumatoid arthritis(RA)(SMD = 0.33; 95% CI: 0.19 to 0.47; SMD = 1.90; 95% CI: 0.13 to 3.67; SMD = 0.75; 95% CI: 0.23 to 1.28). Platelet–lymphocyte ratio (PLR) was found increased in RA and SLE (SMD = 33.91; 95% CI: 20.50 to 47.32; SMD = 59.11; 95% CI: 4.46 to 113.76). Mean platelet volume (MPV)was irrelevant to BD and SLE by comparing with the healthy control group respectively. (SMD = 0.24; 95% CI: −0.49 to 0.97; SMD = −0.15; 95% CI: −1.77 to 1.48). Red cell distribution width (RDW) was not related to AS (SMD = 0.59, 95% CI: −0.37, 1.55). Our findings indicated that NLR had a strong association with AS, BD, and RA. PLR was also related to RA and SLE. NLR and PLR could be recommended as inexpensive diagnostic biomarkers for ARDs.
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Schmoeller D, Picarelli MM, Paz Munhoz T, Poli de Figueiredo CE, Staub HL. Mean Platelet Volume and Immature Platelet Fraction in Autoimmune Disorders. Front Med (Lausanne) 2017; 4:146. [PMID: 28932736 PMCID: PMC5592196 DOI: 10.3389/fmed.2017.00146] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/17/2017] [Indexed: 12/18/2022] Open
Abstract
Mean platelet volume (MPV), measured using automated blood analysers, has been appraised as a potential biomarker in cardiovascular disease, diabetes mellitus, and cancer. The test, a useful tool in differentiation of thrombocytopenic states, has now been carried out for autoimmune disorders, but data are yet scarce. Controversial results have been obtained in systemic and organ-specific autoimmune disorders. Another test, the immature platelet fraction (IPF) reflects the amount of young, reticulated platelets. IPF is calculated by automated hematology analysis or flow cytometry, and it is usually high in patients with rapid platelet destruction. For both MPV and IPF, standardization of cutoff is a major need. In this review, we focus the current applicability of MPV and IPF as biomarkers in patients with autoimmune diseases.
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Affiliation(s)
- Deonilson Schmoeller
- Rheumatology Department, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Maria Mercedes Picarelli
- Rheumatology Department, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Terezinha Paz Munhoz
- Pathology Laboratory, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | | | - Henrique Luiz Staub
- Rheumatology Department, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
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Abstract
OBJECTIVES Cholesteatoma is a chronic inflammatory clinical disorder, and it may cause hearing loss and various complications due to its destructive nature. Mean platelet volume (MPV) is a prothrombotic and proinflammatory marker. The aim of this study is to investigate predictive values of MPV, neutrophil-to-lymphocyte ratio, erythrocyte distribution width, and platelet lymphocyte ratio in cholesteatomatous or noncholesteatomatous pediatric chronic otitis media. METHODS In this study, the authors retrospectively analyzed 24 patients with cholesteatomatous chronic otitis media, 9 patients with noncholesteatomatous chronic otitis media, and 36 age- and sex-matched healthy controls. Cholesteatomatous and noncholesteatomatous chronic otitis media groups were compared with each other, and with controls for WBC, MPV, erythrocyte distribution width, neutrophil-to-lymphocyte ratio, and platelet lymphocyte ratio. RESULTS Mean platelet volume was significantly lower in patients with cholesteatoma (8.17 ± 1.22 fL) compared with the control group (10.42 ± 0.87 fL) (P <0.001). Region of conversion curve analysis showed that the cutoff level of 9.5 fL for MPV was an independent predictor for cholesteatoma with a high sensitivity (86%) and specificity (84%). Cholesteatomatous and noncholesteatomous chronic otitis media patients were similar for other parameters studied. CONCLUSION Mean platelet volume may be used as a fast-to-obtain, reliable, and inexpensive marker with a high predictive level to indicate cholesteatoma in children.
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Ayna AB, Ermurat S, Coşkun BN, Harman H, Pehlivan Y. Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis. Arch Rheumatol 2017; 32:21-25. [PMID: 30375538 PMCID: PMC6190939 DOI: 10.5606/archrheumatol.2017.5886] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 04/05/2016] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This study aims to evaluate the role of neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) as activation and inflammatory markers in systemic lupus erythematosus (SLE) patients with nephritis. PATIENTS AND METHODS A total of 108 SLE patients (8 males, 100 females; mean age 35.3±10.2 years; range 16 to 64 years) including 78 patients with renal involvement (8 males, 70 females; mean age 33.9±10.6 years; range 16 to 64 years) (SLEn+ group) and 30 patients without renal involvement (30 females; mean age 39.1±8.2 years; range 22 to 55 years) (SLEn- group) were included in this retrospective study. All patients' clinical characteristics and laboratory data which include erythrocyte sedimentation rate, C-reactive protein, white blood counts, neutrophil counts, lymphocyte counts, platelet counts, and MPV levels were obtained from medical records. The laboratory data at the highest proteinuria periods of the patients with renal involvement were recorded. RESULTS Mean MPV (SLEn+ =9.1±2.2, SLEn- =7.9±1.2, p=0.001) and NLR (SLEn+ =5.9±5.9, SLEn- =2.6±2.5, p<0.001) values were significantly higher in lupus nephritis group. Besides, a positive correlation between NLR and C-reactive protein was found in lupus nephritis group (r=1.97, p=0.045). Based on receiver operating characteristic curve with area under the curve of 0.76, cutoff NLR value of 1.93 had 83% sensitivity and 54% specificity [95% confidence interval, 0.66-0.85] in differentiating SLE patients with or without nephritis. CONCLUSION Neutrophil to lymphocyte ratio and MPV may be discriminative for lupus nephritis. Also, NLR may be a predictor of lupus nephritis. Both MPV and NLR values may be affected by a great number of factors; therefore, further prospective studies are needed to evaluate the use of these parameters in SLE.
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Affiliation(s)
- Ata Bora Ayna
- Department of Physical and Rehabilitation, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Selime Ermurat
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Belkis Nihan Coşkun
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
| | - Halil Harman
- Department of Physical and Rehabilitation, Division of Rheumatology, Medical Faculty of İzzet Baysal Training and Research Hospital, Bolu, Turkey
| | - Yavuz Pehlivan
- Department of Internal Medicine, Division of Rheumatology, Medical Faculty of Uludağ University, Bursa, Turkey
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Sezgin M, Tecer D, Kanık A, Kekik FS, Yeşildal E, Akaslan E, Yıldırım G, Şahin G. Serum RDW and MPV in Ankylosing Spondylitis: Can they show the disease activity? Clin Hemorheol Microcirc 2017; 65:1-10. [DOI: 10.3233/ch-162067] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Melek Sezgin
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
| | - Duygu Tecer
- Gazi University Medical Faculty, Department of Physical Medicine and Rehabilitation, Ankara, Turkey
| | - Arzu Kanık
- Mersin University Medical Faculty, Department of Biostatistics and Medical Informatics, Mersin, Turkey
| | - Fulya Sultan Kekik
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
| | - Evren Yeşildal
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
| | - Erbil Akaslan
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
| | - Gonca Yıldırım
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
| | - Günşah Şahin
- Mersin University Medical Faculty, Department of Physical Medicine and Rehabilitation, Mersin, Turkey
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Development of Atherosclerotic Cardiovascular Mortality in Gouty Arthritis and Rheumatoid Arthritis Patients: Are They Associated With Mean Platelet Volume and Neutrophil-Lymphocyte Ratio? A Comparative Study. Arch Rheumatol 2017; 32:39-45. [PMID: 30375526 DOI: 10.5606/archrheumatol.2017.6033] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/30/2016] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to evaluate the mean platelet volume (MPV) and neutrophil-lymphocyte ratio (NLR) in gouty arthritis (GA) and rheumatoid arthritis (RA) patients, as well as their relationship with atherosclerotic cardiovascular mortality (ACVM). Patients and methods The study included 122 GA patients (96 males, 26 females; mean age 64.6±13.4 years; range 34 to 82 years), 82 RA patients (40 males, 42 females; mean age 62.1±12.1 years; range 29 to 83 years), and 61 healthy controls (34 males, 27 females; mean age 65.3±4.8 years; range 33 to 80 years). Clinical and ACVM data were obtained from medical charts. Erythrocyte sedimentation rate, C-reactive protein, MPV, and NLR were recorded at the time of diagnosis and one month after therapy. Results Mean platelet volume in GA (8.49±1.5) and RA (7.98±0.99) groups were significantly lower than in healthy controls (9.8±15) (p<0.001). NLR in healthy controls (1.9±0.74) was significantly lower than in GA (3.6±2.3) and RA (3.7±2.5) groups (p<0.001). After treatment, MPV did not change significantly in GA and RA groups (p values >0.05); however, NLR decreased in both groups (p<0.001). Nine GA and 12 RA patients died from ACVM during follow-up. GA patients with ACVM were older and had more frequent hypertension, higher MPV, and higher intercritical CRP level. In multivariate analysis, MPV was an independent poor prognostic factor for ACVM in GA patients. Conclusion Gouty arthritis and RA patients had significantly lower MPV and significantly higher NLR than controls. MPV might be used as a potential biomarker for the development of ACVM in GA.
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Şenel E, Acar B, Demir E. Mean Platelet Volume: A Reliable Marker of Inflammation in Recurrent Apthous Stomatitis and Behçet Disease? Indian Dermatol Online J 2017; 8:468-470. [PMID: 29204391 PMCID: PMC5707840 DOI: 10.4103/idoj.idoj_405_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Background: Mean platelet volume (MPV) is an indicator of platelet activation and aggregation. MPV has been found to be related with the inflammation of certain disorders in recent studies. Aims: We sought to investigate whether MPV could be an indicator of inflammation in patients with Behçet disease (BD) and recurrent apthous stomatitis (RAS). Materials and Methods: Our study was designed as a retrospective case-control study and data was retrieved from our institutional database. We randomly generated a total of three study groups from our clinical archive. All controls were sex and age-matched and randomly selected by computer. Eighty-five patients with BD, 82 patients with RAS, and 721 healthy controls were included for the study design. We compared mean MPV values in the patient groups and controls. Results: We found no difference in the mean MPV value between BD group and BD-control group. The mean MPV value was significantly higher in patients with RAS than that in the RAS-control group (9.11 ± 1.01 fL vs. 8.76 ± 1.15 fL, P = 0.045). There was no difference in mean MPV level between BD and RAS group. Conclusion: The association between MPV and inflammatory skin diseases such as BD and RAS should be investigated prospectively in case-control studies. Limitations: Retrospective study design.
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Affiliation(s)
- Engin Şenel
- Department of Dermatology, Faculty of Medicine, Hitit University, Çorum, Turkey.,Beekeeping and Bee Products Application and Research Center, Hitit University, Çorum, Turkey
| | - Bilal Acar
- Clinic of Internal Medicine, Çankırı State Hospital, Çankırı, Turkey
| | - Emre Demir
- Department of Biostatistics, Faculty of Medicine, Hitit University, Çorum, Turkey
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Tecer D, Sezgin M, Kanık A, İncel NA, Çimen ÖB, Biçer A, Şahin G. Can mean platelet volume and red blood cell distribution width show disease activity in rheumatoid arthritis? Biomark Med 2016; 10:967-74. [DOI: 10.2217/bmm-2016-0148] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: To evaluate the relationship between mean platelet volume (MPV) and red cell distribution width (RDW), and disease activity in rheumatoid arthritis (RA). Patients & methods: Hundred RA and 100 controls were included. Results: MPV and RDW were higher in RA (p < 0.0001). The cut-off levels of RDW and MPV were 14.8 and 10.4. Patients with RDW >14.8 had higher Disease Activity Score 28 (DAS28; p = 0.002) and pain score (p = 0.0007). RDW was positively correlated with DAS28 and pain. But, DAS28 and pain were not different between patients with MPV >10.4 and <10.4. Conclusion: MPV and RDW were significantly higher in RA. RDW and MPV were similar to erythrocyte sedimentation rate and C-reactive protein to indicate inflammatory activity. RDW was correlated with pain and DAS28, but MPV was not associated with them.
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Affiliation(s)
- Duygu Tecer
- Department of Physical Medicine & Rehabilitation, Division of Rheumatology, Gazi University Medical Faculty, Ankara, Turkey
| | - Melek Sezgin
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Arzu Kanık
- Department of Biostatistics & Medical Informatics, Mersin University Medical Faculty, Mersin, Turkey
| | - Nurgül Arıncı İncel
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Özlem Bölgen Çimen
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Ali Biçer
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
| | - Günşah Şahin
- Department of Physical Medicine & Rehabilitation Mersin, Mersin University Medical Faculty, Mersin, Turkey
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Peng YF, Guo J, Deng YB. The role of mean platelet volume in patients with Takayasu arteritis. Ann Clin Biochem 2016; 54:273-278. [PMID: 27329216 DOI: 10.1177/0004563216658312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Takayasu arteritis is a chronic non-specific inflammatory disease and mean platelet volume can either be decreased or increased during inflammation. However, there are no published data to confirm an association between mean platelet volume and Takayasu arteritis. Our aim was to evaluate the role of mean platelet volume in patients with Takayasu arteritis. Methods A total of 119 consecutive patients with Takayasu arteritis and 217 healthy individuals were included in this study. Forty-five Takayasu arteritis patients with active disease were followed with prednisone therapy. Results Mean platelet volume of patients was low compared with control groups (10.1 ± 1.47 fL vs. 11.2 ± 0.91 fL; P < 0.001). Mean platelet volume was lower in active Takayasu arteritis than in inactive Takayasu arteritis patients (9.3 ± 1.39 fL vs. 10.6 ± 1.28 fL; P< 0.001). Mean platelet volume values were significantly increased after prednisone treatment (9.3 ± 1.45 fL vs. 10.5 ± 1.29 fL; P < 0.001). Mean platelet volume negatively correlated with C-reactive protein, erythrocyte sedimentation rate, neutrophil count and platelet count (r = − 0.219, P = 0.018; r = − 0.296, P < 0.001; r = − 0.273, P = 0.003; r =−0.486, P< 0.001), and positively correlated with platelet distribution width (r=0.304, P ≤ 0.001) in patients with Takayasu arteritis. An inverse correlation between mean platelet volume and erythrocyte sedimentation rate was observed in active Takayasu arteritis patients (r = −0.406, P = 0.010). In multiple linear regression analysis, mean platelet volume was independently correlated with erythrocyte sedimentation rate in patients with Takayasu arteritis. Conclusions Our results suggest that mean platelet volume may identify active disease in patients with Takayasu arteritis, and the values of mean platelet volume may help to establish remission of active disease after treatment in Takayasu arteritis patients.
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Affiliation(s)
- You-Fan Peng
- Department of Laboratory Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Jing Guo
- Department of Dermatology, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
| | - Yi-Bin Deng
- Department of Laboratory Medicine, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China
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Ergül AB, Torun YA, Uytun S, Aslaner H, Kısaaslan AP, Şerbetçi MC. Reduction in mean platelet volume in children with acute bronchiolitis. Turk Arch Pediatr 2016; 51:40-5. [PMID: 27103863 DOI: 10.5152/turkpediatriars.2016.3140] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/17/2015] [Indexed: 11/22/2022]
Abstract
AIM Platelets which are known to play a role in inflamation change their shapes when they are activated and this change is reflected in mean platelet volume and platelet distribution width values. Therefore, the mean platelet volume and platelet distribution width values are considered to be beneficial parameters for the diagnosis and treatment of many inflammatory diseases. The aim of the study was to evaluate platelet volume indices in children with acute bronchiolitis. MATERIAL AND METHODS A total of 514 infants who were below the age of 2 years old were evaluated in this study. Three hundred thirteen of these infants were diagnosed with acute bronchiolitis patients and 201 were healthy children. The patients were separated into four groups as mild, moderate, severe bronchiolitis and the control patient group. The groups were evaluated in terms of significant differences in the values of mean platelet volume and platelet distribution width. A p value of <0.05 was considered statistically significant for all results. RESULTS The mean platelet volume was found to be 6.8±0.6 fL in the patients with mild bronchiolitis attack, 6.7±0.6 fL in the patients with moderate bronchiolitis attack, 6.5±0.5 fL in the patients with severe bronchiolitis attack and 7.3±1.1 fL in the control group. The mean platalet volume was statistically significantly lower in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). The platelet distribution width was found to be 17.2%±0.83 in the mild bronchiolitis attack group, 17.1%±0.96 in the moderate bronchiolitis attack group, 17.3%±0.87 in the severe bronchiolitis attack group and 16.9±1.6% in the control patient group. This difference was not statistically significant (p=0.159). The platelet count was statistically significantly higher in the mild, moderate and severe bronchiolitis attack groups compared to the control group (p=0.000). CONCLUSIONS The mean platalet volume is decreased in patients with acute bronchiolitis. It is not a useful criterion in determining the severity of bronchiolitis attack. It is important that clinicians evaluating hemogram results to also interprete this variable.
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Affiliation(s)
- Ayşe Betül Ergül
- Clinic of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Yasemin Altuner Torun
- Clinic of Pediatrics, Hematology Unit, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Salih Uytun
- Clinic of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Hümeyra Aslaner
- Clinic of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ayşenur Paç Kısaaslan
- Department of Pediatric Rheumatology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Mahmut Can Şerbetçi
- Clinic of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
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Hughes M, Herrick AL. Digital ulcers in systemic sclerosis. Rheumatology (Oxford) 2016; 56:14-25. [PMID: 27094599 DOI: 10.1093/rheumatology/kew047] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/15/2016] [Indexed: 11/14/2022] Open
Abstract
Digital ulcers (DUs) are a common visible manifestation of the progressive vascular disease that characterizes the SSc disease process. DUs not only impact significantly on patients' quality of life and hand function, but are also a biomarker of internal organ involvement and of disease severity. The aetiology of (digital) vascular disease in SSc is multifactorial, and many of these factors are potentially amenable to therapeutic intervention. The management of DU disease in SSc is multifaceted. Patient education and non-pharmacological interventions (e.g. smoking cessation) should not be neglected. There are a number of drug therapies available to prevent (e.g. phosphodiesterase type-5 inhibitors and ET receptor-1 antagonists) and treat (e.g. i.v. iloprost) DUs. DUs are also important for two other reasons: firstly, as a primary end point in SSc-related clinical trials; and secondly, DUs are included in the ACR/EULAR SSc classification criteria. However, the reliability of rheumatologists to grade DUs is poor to moderate at best, and this poses challenges in both clinical practice and research. The purpose of this review is to provide the reader with a description of the spectrum of DU disease in SSc including pathophysiology, epidemiology and clinical burden, all of which inform the multifaceted approach to management.
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Affiliation(s)
- Michael Hughes
- Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester
| | - Ariane L Herrick
- Centre for Musculoskeletal Research, The University of Manchester, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester.,NIHR Manchester Musculoskeletal Biomedical Research Unit, Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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Huczek Z, Kochman J, Kowara MK, Wilimski R, Scislo P, Scibisz A, Rymuza B, Andrzejewska R, Stanecka P, Filipiak KJ, Opolski G. Baseline platelet indices and bleeding after transcatheter aortic valve implantation. Blood Coagul Fibrinolysis 2016; 26:527-32. [PMID: 25811449 DOI: 10.1097/mbc.0000000000000283] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Bleeding complications are frequent and independently predict mortality after transcatheter aortic valve implantation (TAVI). It has been demonstrated that certain platelet parameters are indicative of platelet reactivity. We sought to determine the possible correlation between simple platelet indices and bleeding complications in patients undergoing TAVI. Platelet indices--platelet count, mean platelet volume (MPV), platelet distribution width and plateletcrit--were measured in 110 consecutive patients on the day preceding TAVI. In-hospital bleeding events after TAVI were assessed according to the Valve Academic Research Consortium-2 classification as any bleeding, major and life-threatening bleeding (MLTB) and need for transfusion. By receiver-operating characteristic analysis, only MPV was able to distinguish between patients with and without any bleeding [area under the curve (AUC) 0.629, 95% confidence interval (CI) 0.531-0.719, P = 0.0342], MLTB (AUC 0.730, 95% CI 0.637-0.811, P = 0.0004) and need for transfusion (AUC 0.660, 95% CI 0.563-0.747, P = 0.0045). By multivariate logistic regression, high MPV (>10.6) and low platelet distribution width (<14.8) were associated with increased risk of any bleeding [odds ratio (OR) 4.08, 95% CI 1.66-10.07, P = 0.0022; and OR 3.82, 95% CI 1.41-10.36, P = 0.0084, respectively] and MLTB (OR 10.76, 95% CI 3.05-38, P = 0.0002; and OR 8.46, 95% CI 1.69-42.17, P = 0.0092, respectively). Additionally, high MPV independently correlated with the need for transfusion (OR 4.11, 95% CI 1.71-9.86, P = 0.0016). Larger and less heterogenic platelets may be associated with increased risk of short-term bleeding complications after TAVI.
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Affiliation(s)
- Zenon Huczek
- a1st Department of Cardiology bDepartment of Cardiosurgery c2nd Department of Anesthesiology and Intensive Therapy, Medical University of Warsaw, Warsaw, Poland
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Sarıca MA, Kızıldağ B, Selçuk MY, Tutak AŞ, Baykan AH, Bulut HT, Türkbeyler İH. Mean Platelet Volume in Patients with Chronic Venous Insufficiency. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2016. [DOI: 10.5799/jcei.328685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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El-Garf K, Marzouk H, Farag Y, Rasheed L, El-Garf A. Mean platelet volume is a marker of inflammation but not a marker of disease activity in children with juvenile SLE. EGYPTIAN RHEUMATOLOGIST 2016. [DOI: 10.1016/j.ejr.2015.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Yolbas S, Yildirim A, Gozel N, Uz B, Koca SS. Hematological Indices May Be Useful in the Diagnosis of Systemic Lupus Erythematosus and in Determining Disease Activity in Behçet's Disease. Med Princ Pract 2016; 25:510-516. [PMID: 27348861 PMCID: PMC5588503 DOI: 10.1159/000447948] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 06/23/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the relationships between clinical features of rheumatic diseases and hematologic indices, including mean platelet volume (MPV), MPV/platelet ratio (MPR), platelet/lymphocyte ratio, and neutrophil/lymphocyte ratio (NLR). Subjects andMethods: Rheumatoid arthritis (RA; n = 91), systemic lupus erythematosus (SLE; n = 51), systemic sclerosis (SSc; n = 39), and Behçet's disease (BD; n = 53) patients, and 55 healthy controls (HC) were enrolled. Hematological indices were calculated and one-way analysis of variance, Mann-Whitney U and χ2 tests, and receiver operating characteristic (ROC) analyses were performed. RESULTS The MPV and MPR were higher in the SLE group than the RA group (p < 0.05 and p < 0.01, respectively). ROC analysis indicated that MPV (area under the curve, AUC, 0.68, 95% CI 0.58-0.77) and MPR (AUC 0.69, 95% CI 0.59-0.78) were sensitive and specific markers for SLE against RA. The NLR was higher in the RA, SLE, and SSc groups compared to the HC group (p < 0.05, p < 0.001, and p < 0.01, respectively). The NLR was higher in the active BD patients than those that were inactive (p = 0.008). Besides, NLR was higher in patients with neuro-BD and patients with active genital ulcers compared to patients without neurological involvement (p < 0.01) and active genital ulcers (p < 0.05). CONCLUSION The MPV and MPR were significantly higher in the SLE group than in the RA group. They were also higher in the active than in the inactive BD patients. The MPV and MPR are useful diagnostic tools for SLE, and NLR reflects disease activity in BD. However, further research should be performed to standardize these tools.
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Affiliation(s)
- Servet Yolbas
- Department of Rheumatology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Ahmet Yildirim
- Department of Rheumatology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Nevzat Gozel
- Department of Internal Medicine, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Burak Uz
- Department of Hematology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Suleyman Serdar Koca
- Department of Rheumatology, Faculty of Medicine, Firat University, Elazig, Turkey
- *Prof. Suleyman Serdar Koca, MD, Firat Universitesi Hastanesi Romatoloji Klinigi, TR-23200 Elazig (Turkey), E-Mail
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Zheng YG, Yang T, Xiong CM, He JG, Liu ZH, Gu Q, Zhao ZH, Ni XH. Platelet distribution width and mean platelet volume in idiopathic pulmonary arterial hypertension. Heart Lung Circ 2014; 24:566-72. [PMID: 25573235 DOI: 10.1016/j.hlc.2014.11.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 11/12/2014] [Accepted: 11/27/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Previous studies have demonstrated that platelet activation occurs in patients with pulmonary arterial hypertension (PAH). Mean platelet volume (MPV) and platelet distribution width (PDW) are two markers of platelet activation, and have recently been recognised as risk predictors of cardiovascular diseases. This study aimed to investigate whether MPV and PDW would be useful to reflect disease severity and predict prognosis in idiopathic PAH (IPAH). METHODS MPV and PDW levels were measured in 82 IPAH patients without antiplatelet or anticoagulant treatment on admission and 82 healthy controls. Concurrent collected data included clinical, haemodynamic and biochemical variables. All patients were followed-up from the date of blood testing. The endpoint was all-cause mortality. RESULTS MPV and PDW were significantly higher in patients with IPAH than in age and sex-matched control subjects (11.4±0.9fl vs. 10.3±0.9fL and 14.3±2.9% vs. 11.9±1.9%, respectively; p=0.000). Pearson's correlation analysis revealed that MPV and PDW correlated positively with right ventricular systolic pressure, mean pulmonary arterial pressure and pulmonary vascular resistance. After a mean follow-up of 14±8 months, 12 patients died of right heart failure. Receiver operating characteristic analysis showed that MPV and PDW could not predict all-cause mortality. Multivariate Cox regression analysis suggested that right/left ventricular end-diastolic diameter ratio and NT-proBNP were independent predictive parameters of all-cause mortality. CONCLUSIONS Our results suggest that MPV and PDW were elevated in patients with IPAH. They could partly reflect disease severity, but did not predict prognosis.
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Affiliation(s)
- Ya-Guo Zheng
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Tao Yang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Chang-Ming Xiong
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China.
| | - Jian-Guo He
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Zhi-Hong Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Qing Gu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Zhi-Hui Zhao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
| | - Xin-Hai Ni
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Xicheng District, Beijing, 100037, China
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Coşkun BN, Öksüz MF, Ermurat S, Tufan AN, Oruçoğlu N, Doğan A, Dalkılıç E, Pehlivan Y. Neutrophil lymphocyte ratio can be a valuable marker in defining disease activity in patients who have started anti-tumor necrosis factor (TNF) drugs for ankylosing spondylitis. Eur J Rheumatol 2014; 1:101-105. [PMID: 27708888 DOI: 10.5152/eurjrheumatol.2014.034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/12/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Neutrophil lymphocyte ratio (NLR) has emerged as a valuable and reliable method for follow-up of systemic inflammatory disease. We herein aimed to evaluate the role of NLR in the clinical follow-up of inflammation and also to compare its relationship with other measures, such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). MATERIAL AND METHODS A total of 35 active ankylosing spondylitis (AS) and 38 healthy volunteers were included in the study. The patient group was enrolled for treatment with one anti-tumor necrosis factor (TNF) drug. Total blood count, ESR, CRP, and BASDAI score were obtained before and 3 months following the treatment. NLR was found with a mathematical calculation of the ratio of neutrophils with lymphocytes. RESULTS The mean NLR value of the control group and patients was 1.90±0.89 and 2.67±1.17, respectively (p<0.05). After a 3-month course of treatment, the patient group had a mean NLR value of 1.8±0.7, which was significantly lower than pretreatment values (p<0.001). The post-treatment mean ESR, CRP, and BASDAI scores were significantly lower than mean baseline scores (p<0.001, p=0.007, p<0.001, respectively). Also, NLR was found to be correlated with BASDAI, ESR, and CRP (r=0.388, p<0.001; r=0.455, p<0.0001; and r=0.3389, p<0.005, respectively). CONCLUSION Neutrophil lymphocyte ratio could be a reliable and easily accessible method for follow-up of patients with AS.
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Affiliation(s)
- Belkıs Nihan Coşkun
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Mustafa Ferhat Öksüz
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Selime Ermurat
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ayşe Nur Tufan
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Nurdan Oruçoğlu
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Akif Doğan
- Department of Internal Medicine, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Ediz Dalkılıç
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
| | - Yavuz Pehlivan
- Department of Rheumatology, Uludağ University Faculty of Medicine, Bursa, Turkey
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