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Rafaqat S, Khalid A, Riaz S, Rafaqat S. Irregularities of Coagulation in Hypertension. Curr Hypertens Rep 2023; 25:271-286. [PMID: 37561240 DOI: 10.1007/s11906-023-01258-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE OF REVIEW This review article summarizes the role of coagulation in the pathogenesis of hypertension. It specifically focuses on significant factors and markers associated with coagulation, including D-dimer, fibrinogen and fibrin, prothrombin, P-selectin, soluble urokinase plasminogen activator receptor, thrombomodulin, tissue factor, tissue plasminogen activator, von Willebrand factor, β-thromboglobulin, and Stuart-Prower factor. RECENT FINDINGS D-dimer levels were elevated in hypertensive individuals compared to healthy controls, and the levels increased with the severity of hypertension. These findings indicate that increased coagulation activity of fibrin plays a role in the development of thromboembolic complications in hypertensive patients. Additionally, both fibrinogen levels and D-dimer levels displayed a positive correlation with the duration of hypertension, suggesting that these biomarkers were positively associated with the length of time an individual had been hypertensive. Increased systolic and diastolic blood pressures have been linked to higher levels of prothrombin time and activated partial thromboplastin time in individuals with hypertension as well as those with normal blood pressure. Also, the presence of P-selectin, produced by activated platelets and endothelial cells during angiotensin II stimulation, played a role in the development of cardiac inflammation and fibrosis associated with hypertension. Moreover, the change in systolic blood pressure was associated with baseline soluble urokinase plasminogen activator receptor (suPAR) in hypertensive participants, and the change in suPAR levels was associated with the development of hypertension. Moreover, it was observed a decrease in thrombomodulin expression in the placenta of preeclamptic patients, suggesting its potential involvement in placental dysfunction, possibly driven by an imbalance in angiogenic factors. Tissue factors and autophagy might have significant implications in the pathogenesis of chronic thromboembolic pulmonary hypertension, particularly in the context of vascular remodelling. Likewise, ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) might be a promising biomarker for the early detection of pulmonary arterial hypertension and the von Willebrand factor is a candidate prognostic biomarker. The arterial β-thromboglobulin levels were significantly lower than venous levels. This article concludes that D-dimer, fibrinogen and fibrin, prothrombin, P-selectin, soluble urokinase plasminogen activator receptor, thrombomodulin, tissue factor, tissue plasminogen activator, von Willebrand factor, and β-thromboglobulin are important factors involved in the pathogenesis of hypertension.
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Affiliation(s)
- Saira Rafaqat
- Department of Zoology (Molecular Physiology), Lahore College for Women University, Lahore, Punjab, Pakistan.
| | - Amber Khalid
- Department of Zoology, Lahore College for Women University, Lahore, Punjab, Pakistan
| | - Saira Riaz
- Department of Environmental Science, Lahore College for Women University, Lahore, Punjab, Pakistan
| | - Sana Rafaqat
- Department of Biotechnology (Human Genetics), Lahore College for Women University, Lahore, Punjab, Pakistan
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Qiu F, Zhang H, He Y, Liu H, Zheng T, Xia W, Xu S, Zhou J, Li Y. Associations of arsenic exposure with blood pressure and platelet indices in pregnant women: A cross-sectional study in Wuhan, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114378. [PMID: 36525950 DOI: 10.1016/j.ecoenv.2022.114378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/14/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental inorganic arsenic (iAs) exposure is potentially related to abnormal blood pressure (BP) changes and abnormal platelet activation. However, limited epidemiological studies have explored the impacts of iAs exposure on platelet change mediated by BP, especially for pregnant women. OBJECTIVES Our purpose was to investigate the associations of arsenic exposure with blood pressure and platelet indices among pregnant women. METHODS The present study population included 765 pregnant women drawn from a prospective birth cohort study in Wuhan, China, recruited between October 2013 and April 2016. Urine sampled in the second trimester were used to assess arsenic species concentrations. The relative distribution of urinary arsenic species was used to measure human methylation capacity. BP parameters and platelet indices originated from the medical record. We applied multivariable linear regression models to explore the cross-sectional relationships between urinary arsenic metabolites, BP parameters, and platelet indices. We utilized mediation analysis to investigate the impacts of arsenic exposure on platelet indices through BP as mediator variables. RESULTS We observed significant positive correlations between iAs and systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Pregnant women with higher methylation capacity to metabolize iAs characterized by higher secondary methylation index (SMI) and total methylation index (TMI) had a more significant reduction in SBP, DBP, and MAP. Pregnant women with higher DBP and MAP had higher platelet counts (PLC). A decreased PLC was found in subjects wither higher SMI. Additionally, SMI was negatively linked to PLC mediated through MAP. CONCLUSIONS Obtained results suggested that higher methylation capacity to metabolize iAs might contribute to decreased PLC among pregnant women, and MAP might mediate the influence of SMI on PLC.
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Affiliation(s)
- Feng Qiu
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | - Yujie He
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieqiong Zhou
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Department of Gynaecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yuanyuan Li
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Hu J, Lv S, Zhou T, Chen H, Xiao L, Huang X, Wang L, Wu P. Identification of Pulmonary Hypertension Animal Models Using a New Evolutionary Machine Learning Framework Based on Blood Routine Indicators. JOURNAL OF BIONIC ENGINEERING 2022; 20:762-781. [PMID: 36466726 PMCID: PMC9703443 DOI: 10.1007/s42235-022-00292-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/17/2023]
Abstract
Pulmonary Hypertension (PH) is a global health problem that affects about 1% of the global population. Animal models of PH play a vital role in unraveling the pathophysiological mechanisms of the disease. The present study proposes a Kernel Extreme Learning Machine (KELM) model based on an improved Whale Optimization Algorithm (WOA) for predicting PH mouse models. The experimental results showed that the selected blood indicators, including Haemoglobin (HGB), Hematocrit (HCT), Mean, Platelet Volume (MPV), Platelet distribution width (PDW), and Platelet-Large Cell Ratio (P-LCR), were essential for identifying PH mouse models using the feature selection method proposed in this paper. Remarkably, the method achieved 100.0% accuracy and 100.0% specificity in classification, demonstrating that our method has great potential to be used for evaluating and identifying mouse PH models.
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Affiliation(s)
- Jiao Hu
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Shushu Lv
- Department of Dermatology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 People’s Republic of China
| | - Tao Zhou
- The First Clinical College, Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Huiling Chen
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Lei Xiao
- Department of Computer Science and Artificial Intelligence, Wenzhou University, Wenzhou, 325035 People’s Republic of China
| | - Xiaoying Huang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Liangxing Wang
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
| | - Peiliang Wu
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 People’s Republic of China
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Bernea EG, Suica VI, Uyy E, Cerveanu-Hogas A, Boteanu RM, Ivan L, Ceausu I, Mihai DA, Ionescu-Tîrgoviște C, Antohe F. Exosome Proteomics Reveals the Deregulation of Coagulation, Complement and Lipid Metabolism Proteins in Gestational Diabetes Mellitus. Molecules 2022; 27:molecules27175502. [PMID: 36080270 PMCID: PMC9457917 DOI: 10.3390/molecules27175502] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/22/2022] [Accepted: 08/25/2022] [Indexed: 11/16/2022] Open
Abstract
Exosomes are small extracellular vesicles with a variable protein cargo in consonance with cell origin and pathophysiological conditions. Gestational diabetes mellitus (GDM) is characterized by different levels of chronic low-grade inflammation and vascular dysfunction; however, there are few data characterizing the serum exosomal protein cargo of GDM patients and associated signaling pathways. Eighteen pregnant women were enrolled in the study: 8 controls (CG) and 10 patients with GDM. Blood samples were collected from patients, for exosomes’ concentration. Protein abundance alterations were demonstrated by relative mass spectrometric analysis and their association with clinical parameters in GDM patients was performed using Pearson’s correlation analysis. The proteomics analysis revealed 78 significantly altered proteins when comparing GDM to CG, related to complement and coagulation cascades, platelet activation, prothrombotic factors and cholesterol metabolism. Down-regulation of Complement C3 (C3), Complement C5 (C5), C4-B (C4B), C4b-binding protein beta chain (C4BPB) and C4b-binding protein alpha chain (C4BPA), and up-regulation of C7, C9 and F12 were found in GDM. Our data indicated significant correlations between factors involved in the pathogenesis of GDM and clinical parameters that may improve the understanding of GDM pathophysiology. Data are available via ProteomeXchange with identifier PXD035673.
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Affiliation(s)
- Elena G. Bernea
- “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 020474 Bucharest, Romania
| | - Viorel I. Suica
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
| | - Elena Uyy
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
| | - Aurel Cerveanu-Hogas
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
| | - Raluca M. Boteanu
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
| | - Luminita Ivan
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
| | - Iuliana Ceausu
- University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
- “Dr. I. Cantacuzino” Hospital, 020475 Bucharest, Romania
| | - Doina A. Mihai
- “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 020474 Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
| | - Constantin Ionescu-Tîrgoviște
- “Prof. N. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, 020474 Bucharest, Romania
- University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
| | - Felicia Antohe
- Institute of Cellular Biology and Pathology “Nicolae Simionescu”, 050568 Bucharest, Romania
- Correspondence: ; Tel.: +40213194518
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Akın H, Bilge Ö, Yavuz B, Özkan S, Işık F. The relationship between mean platelet volume and resistant hypertension. Clin Exp Hypertens 2022; 44:228-232. [PMID: 34974786 DOI: 10.1080/10641963.2021.2022686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Resistant hypertension (RH) is associated with an increased risk of cardiovascular events.Mean platelet volume (MPV) has been shown to indicate platelet activation and is associated with increased cardiovascular disease risk. In our study, we aimed to evaluate the relationship between mean platelet volume and resistant hypertension. METHOD A total of 279 patientswere included in our study and divided into three groups (GroupI: seventy-eight patients with resistant hypertension, group II: seventy-nine patients with controlled hypertension and group III: one-hundred-five patients without hypertension). Routine laboratory tests and ambulatory blood pressure measurement (ABPM) were followed up in all patients. RESULTS Of the patients in the study, 25% were female while 75% were male, and the mean age was 56.5 ± 11.8 years. The mean MPV values were found to be 9.34 ± 1.49 fL in the RHT group, 8.82 ± 0.83 fLin the controlled HT group, and 8.5 ± 0.85 fL in the normotensive individuals, and there was a significant correlation between the RHT group and the other groups (RHT versus controlled HT p1 = 0.008, RHT versus normotensive individuals p2 < 0,001). When we compared controlled HT and normotensive individuals, no significant relationship was found between MPV values (p3 = 0,157). CONCLUSION The MPV value was found to be higher in resistant hypertensive patients compared to controlled hypertensive and normotensive patients. MPV values can be used to predict adverse cardiovascular events in RHT patients.
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Affiliation(s)
- Halil Akın
- Department of Cardiology, Private Medicalpark Hospital, Ankara, Turkey
| | - Önder Bilge
- Department of Cardiology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
| | - Bünyamin Yavuz
- Department of Cardiology, Yuksek Ihtisas UniversityPrivate Medicalpark Hospital, Ankara, Turkey
| | - Selçuk Özkan
- Department of Cardiology, Yuksek Ihtisas UniversityPrivate Medicalpark Hospital, Ankara, Turkey
| | - Ferhat Işık
- Department of Cardiology, Diyarbakır Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey
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Zhang Y, Peng R, Li X, Cheng G, Wang X, Yu J, Hua M, Chen X, Zhou Z. Clopidogrel versus ticagrelor in the treatment of Chinese patients undergoing percutaneous coronary intervention: effects on platelet function assessed by platelet function tests and mean platelet volume. Thromb J 2021; 19:97. [PMID: 34876147 PMCID: PMC8650403 DOI: 10.1186/s12959-021-00350-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 11/18/2021] [Indexed: 11/14/2022] Open
Abstract
Background Knowledge on the pharmacodynamic effects of antiplatelet drugs including clopidogrel and ticagrelor on Asian patients is scarce. We aim to evaluate the effects of the two drugs on platelet reactivity in the treatment of Chinese patients who underwent percutaneous coronary intervention (PCI), using two platelet function tests (PFT). Meanwhile, the relationship between mean platelet volume (MPV), a routine index of platelet size, and high on-treatment platelet reactivity (HPR) is also investigated. Methods Patients receiving dual antiplatelet therapy (DAPT) were scheduled for the assessment of platelet reactivity at 2–3 days after PCI. Two PFTs, light transmission aggregometry (LTA) and vasodilator-stimulated phosphoprotein (VASP)-FCM assay, were applied in the evaluation of platelet reactivity. The MPV was measured simultaneously with EDTA plasma using a Sysmex XN 2000 automated hematology analyzer. Results The final study population included the aspirin + clopidogrel group (n = 46) and the aspirin + ticagrelor group (n = 66). In the aspirin + ticagrelor group, the maximal light transmittance (LT) changes in response to 5 μM ADP assessed by LTA was obviously lower than that in the aspirin + clopidogrel group (P < 0.001). The platelet reactivity index (PRI) level in the VASP test was also markedly lower in the group given aspirin and ticagrelor (P < 0.001). There was a significant difference in HPR between the two groups. MPV showed a potent ability to predict the presence of HPR at VASP assay (AUC = 0.788, 95% CI: 0.701–0.875, P < 0.001) in receiver-operating characteristic curve analysis. Conclusions Compared with clopidogrel, ticagrelor has dramatically greater antiplatelet effect, with a superiority in suppressing platelet function and a lower HPR rate. In addition, there existed a significant independent association between MPV and high prevalence of HPR in the VASP assay. Supplementary Information The online version contains supplementary material available at 10.1186/s12959-021-00350-2.
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Affiliation(s)
- Yang Zhang
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Rui Peng
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Xiaojuan Li
- Department of Laboratory Medicine, Yunnan Fuwai Cardiovascular Hospital, Kunming, 650000, China
| | - Gaowa Cheng
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Ximing Wang
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Jinxing Yu
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China
| | - Muxing Hua
- Department of Laboratory Medicine, Yunnan Fuwai Cardiovascular Hospital, Kunming, 650000, China
| | - Xi Chen
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China.
| | - Zhou Zhou
- Diagnostic Laboratory Service, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, No.167, Beilishi Road, Xicheng District, Beijing, 100037, China.
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Khalid K, Padda J, Ismail D, Abdullah M, Gupta D, Pradeep R, Hameed W, Cooper AC, Jean-Charles G. Correlation of Coronary Artery Disease and Left Ventricular Hypertrophy. Cureus 2021; 13:e17550. [PMID: 34646607 PMCID: PMC8479854 DOI: 10.7759/cureus.17550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2021] [Indexed: 12/23/2022] Open
Abstract
Ischemic heart disease (IHD) is the leading cause of death worldwide, and it is defined as an imbalance between myocardial oxygen supply and demand. Coronary artery disease (CAD) and left ventricular hypertrophy (LVH) are two common causes of IHD that independently result in myocardial ischemia. CAD decreases myocardial blood and oxygen supply whereas LVH increases myocardial oxygen demand. The coexistence of both CAD and LVH results in a significant increase in oxygen demand while simultaneously lowering oxygen supply. Since hypertension is a shared predisposing condition for both CAD and LVH, the left ventricular (LV) mass on noninvasive echocardiography can reflect on the severity of coronary artery stenosis. In clinical practice, it can help physicians decide whether to perform invasive cardiac catheterization to visualize the extent of the coronary block. Although, both CAD and LVH are directly proportional to mortality risk, the addition of eccentric LVH can further increase morbidity and mortality due to myocardial infarction. Therefore, the latest management of both the acute and chronic phases of CAD places an increased emphasis on controlling the predisposing factors to prevent or reverse LVH. For example, angiotensin-converting enzyme inhibitors and diuretics reduce LV mass by lowering the cardiac preload and afterload. This article aims to investigate the deleterious effects of the collaboration between CAD and LVH, establish a causal relationship, and explore the new prevention and management strategies.
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Affiliation(s)
- Khizer Khalid
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | - Jaskamal Padda
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | - Dina Ismail
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | | | - Dhriti Gupta
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | - Roshini Pradeep
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | - Warda Hameed
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA
| | | | - Gutteridge Jean-Charles
- Internal Medicine, Jean-Charles (JC) Medical Center, Orlando, USA.,Internal Medicine, AdventHealth & Orlando Health Hospital, Orlando, USA
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Association between central non-dipping pattern and platelet morphology in adults with type 1 diabetes without cardiovascular disease: a cross-sectional study. Sci Rep 2021; 11:15416. [PMID: 34326364 PMCID: PMC8322100 DOI: 10.1038/s41598-021-94414-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/14/2021] [Indexed: 11/15/2022] Open
Abstract
The non-dipping pattern is nighttime systolic blood pressure (SBP) fall of less than 10%. Several studies showed that the non-dipping pattern, increased mean platelet volume (MPV), and platelet distribution width (PDW) are associated with elevated cardiovascular risk. Hypertensives with the non-dipping pattern have higher MPV than the dippers but this relationship was never investigated among people with type 1 diabetes mellitus (T1DM). This study aimed to investigate the association between the central dipping pattern and platelet morphology in T1DM subjects. We measured the central and brachial blood pressure with a validated non-invasive brachial oscillometric device—Arteriograph 24—during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The group was divided based on the central dipping pattern for the dippers and the non-dippers. From a total of 62 subjects (32 males) aged 30.1 (25.7–37) years with T1DM duration 15.0 (9.0–20) years, 36 were non-dippers. The non-dipper group had significantly higher MPV (MPV (10.8 [10.3–11.5] vs 10.4 [10.0–10.7] fl; p = 0.041) and PDW (13.2 [11.7–14.9] vs 12.3 [11.7–12.8] fl; p = 0.029) than dipper group. Multivariable logistic regression revealed that MPV (OR 3.74; 95% CI 1.48–9.45; p = 0.005) and PDW (OR 1.91; 95% CI 1.22–3.00; p = 0.005) were positively associated with central non-dipping pattern adjusting for age, sex, smoking status, daily insulin intake, and height. MPV and PDW are positively associated with the central non-dipping pattern among people with T1DM.
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Li T, Meng Z, Zhang W, Li Y, Yu X, Du X, Liu M, Zhang Q, Gao Y, Song K, Wang X, Fan Y. No obvious association exists between mean platelet volume and hypertension subtypes. Biomark Med 2021; 15:577-584. [PMID: 33988465 DOI: 10.2217/bmm-2020-0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims: To determine the association between mean platelet volume (MPV) and hypertension subtypes. Participants & results: 44,281 Chinese individuals were enrolled in this cross-sectional study. The mean blood pressure decreased with increasing MPV in females (p = 0.001) and increased MPV seemed to be a potential protective factor for isolated diastolic hypertension in models 1 and 2. The OR (CI) was 0.878 (0.789-0.976) for model 1 and 0.880 (0.789-0.981) for model 2 in males and 0.646 (0.495-0.841) for model 1 and 0.657 (0.503-0.858) for model 2 in females, when MPV was analyzed as a categorical variable. The OR (CI) was 0.947 (0.911-0.985) for Model 1 and 0.947 (0.910-0.985) for Model 2 in males, and 0.886 (0.807-0.973) for Model 1 and 0.892 (0.813-0.978) for Model 2 in females when MPV was analyzed as a continuous variable. However, the statistical difference of OR disappeared when we added blood-related covariates in Model 3. Conclusion: No obvious association exists between MPV and hypertension subtypes. Other blood parameters might have a greater impact on hypertension subtypes.
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Affiliation(s)
- Tingwei Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Wenjuan Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yongle Li
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xuefang Yu
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xin Du
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ming Liu
- Department of Endocrinology & Metabolism, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Ying Gao
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Xing Wang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
| | - Yaguang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis & Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, 300052, PR China
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Negro F, Verdoia M, Tonon F, Nardin M, Kedhi E, De Luca G. Impact of gender on immature platelet count and its relationship with coronary artery disease. J Thromb Thrombolysis 2021; 49:511-521. [PMID: 32189190 DOI: 10.1007/s11239-020-02080-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The impact of platelet parameters on the cardiovascular risk is still debated. Gender differences in platelet volume indexes and turnover have been previously reported, potentially conditioning their role in the development of coronary artery disease (CAD). However, few studies have addressed, so far, the impact of gender on the immature platelet fraction (IPF) and count (IPC) and their relationship with CAD. We enrolled consecutive patients undergoing coronary angiography in a single centre. IPF and platelet indexes were measured at admission. Significant CAD was defined as the presence of at least one coronary stenosis more than 50%. A total of 2550 patients were included, 1835 (72%) were males, and 715 (28%) were females. Female patients were older (p < 0.001), with lower BMI (p = 0.002), lower prevalence of active smoking (p < 0.001), previous MI, previous PCI and CABG (p = 0.001, p = 0.001, p < 0.001), whilst a higher prevalence of renal failure (p = 0.02), acute presentation (p < 0.001) and CAD (p < 0.001). Platelet count was higher in females (p < 0.001), as well as the IPC levels (838.38 ± 562.05 vs 792.24 ± 535.66, p = 0.05) with no difference in the levels of immature platelet fraction (3.67 ± 2.68% vs 3.74 ± 2.6%, p = 0.55) or the prevalence of patients with IPF ≥ 3rd tertile (33.7% vs 35.2%, p = 0.26). At multivariate analysis, after correction for baseline confounders, gender did not emerge as an independent predictor of higher IPF (adjusted OR [95% CI] = 0.82 [0.64-1.06], p = 0.13). When dividing our patients according to the levels of IPF, in women we observed an inverse association between IPF ≥ 3rd tertile and coronary calcifications (p = 0.025) and a higher prevalence of restenosis (p = 0.003), but no difference in CAD (65.6% vs 66.9%, p = 0.71) or severe CAD (28.1% vs 24.7%, p = 0.31). In males, the IPF ≥ 3rd tertile related with a lower TIMI flow (p = 0.001). Males with lower IPF had a significantly higher percentage of CAD (87.7% vs 83.3%, p = 0.007; adjusted OR: 0.699 [95% CI] = [0.54-0.91], p = 0.008) but not for severe CAD (36.5% vs 39.9%, p = 0.134). The present study shows that among patients undergoing coronary angiography, gender is not associated to the levels of immature platelet fraction. Moreover, we found no association between IPF and the prevalence and extent of CAD in female gender, whereas in male gender the IPF was inversely related with the prevalence of CAD.
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Affiliation(s)
- Federica Negro
- Department of Translational Medicine, Ospedale "Maggiore Della Carità", Eastern Piedmont University, C.so Mazzini, 18, 28100, Novara, Italy
| | - Monica Verdoia
- Department of Translational Medicine, Ospedale "Maggiore Della Carità", Eastern Piedmont University, C.so Mazzini, 18, 28100, Novara, Italy
- Ospedale Degli Infermi, ASL Biella, Biella, Italy
| | - Francesco Tonon
- Department of Translational Medicine, Ospedale "Maggiore Della Carità", Eastern Piedmont University, C.so Mazzini, 18, 28100, Novara, Italy
| | - Matteo Nardin
- Department of Medicine, ASST "Spedali Civili", University of Brescia, Brescia, Italy
| | - Elvin Kedhi
- Department of Cardiology, ISALA Hospital, Zwolle, The Netherlands
| | - Giuseppe De Luca
- Department of Translational Medicine, Ospedale "Maggiore Della Carità", Eastern Piedmont University, C.so Mazzini, 18, 28100, Novara, Italy.
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Zhang SH, Guo AJ, Wei N, Zhang R, Niu YJ. Associations of urinary dichloroacetic acid and trichloroacetic acid exposure with platelet indices: Exploring the mediating role of blood pressure in the general population. JOURNAL OF HAZARDOUS MATERIALS 2021; 402:123452. [PMID: 32688193 DOI: 10.1016/j.jhazmat.2020.123452] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 06/11/2023]
Abstract
Human exposure to drinking water disinfection by-products (DBPs) is potentially linked to high blood pressure (BP), which may be associated with abnormal platelet activation. This study investigated whether the relationship between DBP exposure with platelet change was mediated by BP. DBP biomarkers, such as urinary dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA), BP and platelet indices from 505 adults from a hospital in Shijiazhuang, China were measured. The cross-sectional associations among DCAA and TCAA exposure, BP and platelet indices were explored through multivariable linear regressions, and the mediation effect of BP was evaluated using the Sobel-Goodman test. We observed that DCAA and TCAA were positively associated with systolic BP (all p for trends < 0.01), which was positively associated with platelet count (PLC) (p for trend < 0.05). Mediation analysis indicated that systolic BP fully mediated the associations of DCAA and TCAA with PLC. When BP was controlled, a previously inverse significant relation between DCAA and platelet distribution width (PDW) remained significant (p < 0.05). Obtained results suggested that exposure to DCAA may contribute to decreased PDW in humans. Systolic BP is a possible mediator of the association between DCAA exposure and PLC. TCAA may indirectly positively affect PLC by increasing systolic BP.
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Affiliation(s)
- Shao-Hui Zhang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, Hebei, PR China; Medical General Laboratory, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Ai-Jing Guo
- Department of Physico-chemical Inspection, Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, Hebei, PR China
| | - Ning Wei
- Medical General Laboratory, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Rong Zhang
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, Hebei, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei, PR China
| | - Yu-Jie Niu
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, Hebei, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei, PR China.
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12
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Park SK, Ryoo JH, Kang JG, Jung JY. Association of left ventricular hypertrophy with the level of thyroid hormone in euthyroid state. J Endocrinol Invest 2021; 44:111-117. [PMID: 32383145 DOI: 10.1007/s40618-020-01277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 04/24/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE It has been demonstrated that variation in thyroid hormone levels even within normal range was associated with increased cardiovascular risk. However, available data are still insufficient on association between left ventricular hypertrophy (LVH) and thyroid hormone levels within euthyroid state. METHODS In 69,298 Koreans with euthyroid function, we evaluated association between echocardiographically detected LVH and thyroid hormone levels within the normal range. Study participants were categorized into elderly (age ≥ 40) and younger (age < 40) groups, where subjects were divided into four groups according to quartile levels of thyroxine (FT4), triiodothyronine (FT3), and thyroid-stimulating hormone (TSH). Multivariable adjusted logistic regression analysis was used to calculate odds ratios (ORs) and 95% confidence interval (CI) for LVH (adjusted ORs [95% CI]) across quartile levels of thyroid hormones. RESULTS In elderly group, adjusted ORs for LVH generally higher in the first quartile group than other quartile groups, despite no statistical significance in some cases (first quartile: reference, second quartile: 0.86 [0.67-1.11] in TSH, 0.75 [0.58-0.95] in FT4 and 0.63 [0.49-0.81] in FT3, third quartile: 0.70 [0.54-0.92] in TSH, 0.79 [0.61-1.02] in FT4 and 0.72 [0.55-0.93] in FT3, fourth quartile: 0.81 [0.65-1.04] in TSH, 0.85 [0.65-1.10] in FT4 and 0.58 [0.44-0.77] in FT3). This finding was similarly found in the younger group, despite discrepancy in some cases. CONCLUSION In euthyroid state, low normal levels in FT4, FT3 and TSH were more strongly associated with LVH.
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Affiliation(s)
- S K Park
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Ryoo
- Department of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - J G Kang
- Total Healthcare Center, KangBuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - J Y Jung
- Total Healthcare Center, KangBuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea.
- School of Medicine, Sungkyunkwan University, Seoul, Korea.
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Nadar SK, Lip GYH. The heart in hypertension. J Hum Hypertens 2020; 35:383-386. [PMID: 33046827 DOI: 10.1038/s41371-020-00427-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/22/2020] [Accepted: 10/01/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Sunil K Nadar
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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14
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Jackson BS, Nunes Goncalves J, Pretorius E. Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis. Retrovirology 2020; 17:14. [PMID: 32571345 PMCID: PMC7310079 DOI: 10.1186/s12977-020-00523-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. METHODS We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen-emtricitabine, tenofovir and efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties using thromboelastography (TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. RESULTS The DVT patients (HIV positive and HIV negative) had raised inflammatory markers. The HIV positive-DVT group had anaemia in keeping with anaemia of chronic disorders. DVT patients had a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient's red blood cells (RBCs) and platelets demonstrated inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. CONCLUSIONS Although there were trends that HIV-positive patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV-negative patients, there were no significant differences between the 2 groups. The sample size was, however, small in number. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV-positive patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.
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Affiliation(s)
- Brandon S Jackson
- Department of Surgery, University of Pretoria, Pretoria, 0007, South Africa
| | | | - Etheresia Pretorius
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, Private Bag X1 Matieland, 7602, South Africa.
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Verdoia M, Nardin M, Negro F, Tonon F, Gioscia R, Rolla R, De Luca G. Impact of aging on immature platelet count and its relationship with coronary artery disease. Platelets 2020; 31:1060-1068. [PMID: 31973643 DOI: 10.1080/09537104.2020.1714572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite the fact that elderly patients represent a prevalent and challenging population in the current practice, few data exist on the impact of platelet parameters on cardiovascular risk in these patients. Therefore, the aim of the present study was to evaluate the impact of age on the immature platelet count (IPC) and their relationship with CAD. We included a total of 2236 consecutive patients undergoing coronary angiography in a single center. Elderly patients (age ≥ 75 years) were 756 (33.7%). IPC was measured at admission. Elderly patients were more often females (p < .001), with lower BMI and prevalence of smokers (p < .001), and a more complex cardiovascular risk profile and coronary disease (p = .02). Platelet count decreased with aging (p = .05), whereas no difference in the mean IPC was found between patients < or ≥75 years. In fact, advanced age did not emerge as an independent predictor of IPC above III tertile (≥8.6*10^6/ml), (adjusted OR[95%CI] = 0.97[0.78-1.21], p = .79). When considering elderly patients according to tertiles values of IPC (<5.1,5.1-8.59; ≥8.6*10^6/ml), we found no impact of IPC on the prevalence of CAD (81.1% vs 84.5% vs 81.5%, p = .92; adjusted OR[95%CI] = 1.08[0.67-1.72], p = .75) and its extent (37.7% vs 34.5% vs 40.2%, p = .57; adjusted OR[95%CI] = 1.22[0.85-1.73], p = .28). However, we observed a higher rate of calcified and type C lesions in elderly patients with higher IPC (p = .03 and p < .001, respectively). Therefore, advanced age is not associated with higher immature platelet count and the prevalence and severity of CAD. Moreover, IPC does not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients.
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Affiliation(s)
- Monica Verdoia
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
| | - Matteo Nardin
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy.,Department of Medicine, ASST "Spedali Civili", University of Brescia , Brescia, Italy
| | - Federica Negro
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
| | - Francesco Tonon
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
| | - Rocco Gioscia
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
| | - Roberta Rolla
- Department of Clinical Chemistry, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
| | - Giuseppe De Luca
- Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy
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16
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An X, Jiang G, Cheng C, Lv Z, Liu Y, Wang F. Inhibition of Platelets by Clopidogrel Suppressed Ang II-Induced Vascular Inflammation, Oxidative Stress, and Remodeling. J Am Heart Assoc 2019; 7:e009600. [PMID: 30608200 PMCID: PMC6404205 DOI: 10.1161/jaha.118.009600] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Platelets play a role in promoting inflammatory responses under several disease conditions. Platelets are activated in hypertensive patients. However, the mechanisms responsible for platelet‐mediating vascular inflammation are unknown. The present study investigated the role of platelets in promoting vascular inflammation following angiotensin II (Ang II) stimulation, and the efficacy of antiplatelet intervention. Methods and Results Within a mouse model of Ang II infusion (490 ng/kg per min), we measured the portion of P‐selectin–positive platelets and platelet‐monocyte (P‐M) binding in blood samples, and platelet accumulation and P‐M binding in vessels under Ang II stimulation at days 1, 3, and 7. We tested the efficacy of clopidogrel (15 mg/kg per day, followed by 5 mg/kg per day) on Ang II‐induced platelet activation, P‐M binding, vascular platelet accumulation, as well as vascular inflammation and remodeling at day 7 or 14. Clopidogrel reduced platelet vascular deposition (28.7±2.4% versus 18.3±2.9%), suppressed inflammatory cell infiltration (3.6±0.8×104/vessel versus 2.3±1.2×104/vessel) and oxidative stress, and attenuated vascular remodeling and dysfunction (55.0±5.5% versus 84.0±6.0%) following Ang II stimulation at day 7 or 14. Clopidogrel suppressed Ang II‐induced P‐M binding both at circulating (13.4±3.3% versus 5.9±2.7%) and regional (33.4±4.3% versus 11.9±2.7%) levels. Conclusions Platelets play a critical role in vascular inflammation under Ang II stimulation, with a marked promotion of P‐M binding as an important mechanism. Clopidogrel prevented vascular inflammation in Ang II‐infused mice.
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Affiliation(s)
- Xiangbo An
- 1 Department of Interventional Therapy the First Affiliated Hospital of Dalian Medical University Dalian China.,3 Institute of Cardiovascular Diseases the First Affiliated Hospital of Dalian Medical University Dalian China
| | - Guinan Jiang
- 1 Department of Interventional Therapy the First Affiliated Hospital of Dalian Medical University Dalian China.,3 Institute of Cardiovascular Diseases the First Affiliated Hospital of Dalian Medical University Dalian China
| | - Cheng Cheng
- 4 Center for Clinical Research on Neurological Diseases the First Affiliated Hospital of Dalian Medical University Dalian China
| | - Zhengshuai Lv
- 2 Department of Anesthesia the First Affiliated Hospital of Dalian Medical University Dalian China
| | - Yang Liu
- 3 Institute of Cardiovascular Diseases the First Affiliated Hospital of Dalian Medical University Dalian China
| | - Feng Wang
- 1 Department of Interventional Therapy the First Affiliated Hospital of Dalian Medical University Dalian China
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Meric M, Yuksel S, Coksevim M, Gulel O. The Effect of Mean Platelet Volume/Platelet Count Ratio on Dipper and Non-Dipper Blood Pressure Status. ACTA ACUST UNITED AC 2019; 55:medicina55110742. [PMID: 31744048 PMCID: PMC6915530 DOI: 10.3390/medicina55110742] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 01/11/2023]
Abstract
Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 ± 0.007 to 0.032 ± 0.004 fL/[109/L]; 0.046 ± 0.007 to 0.026 ± 0.004 fL/[109/L], p < 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p < 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.
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Affiliation(s)
- Murat Meric
- Correspondence: ; Tel.: +90-362312-1919 (ext. 3249)
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Karataş M, Taşolar H. The Effect of Marked Nasal Septal Deviation on Left Ventricular Function and Blood Markers. J Craniofac Surg 2019; 30:803-807. [PMID: 30653035 DOI: 10.1097/scs.0000000000005112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study aimed to assess the effect of nasal septoplasty in patients with marked nasal septal deviation (MNSD) on subjective perception of nasal patency, echocardiography, and hematologic parameters. METHODS Seventy-nine consecutive patients (mean age, 29.9 ± 9.7 years; 57 men and 22 women) at least 18 years old were diagnosed as MNSD consistent with presenting symptom of chronic nasal obstruction lasting at least 3 months. Complete blood count measurement to assess mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR), the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire, and echocardiography were performed for all patients just before and at postoperative third month of septoplasty. RESULTS The MPV (0.021), NLR (<0.001), and NOSE (<0.001) were all significantly decreased, and global longitudinal strain (GLS) value (<0.001) were also significantly increased at postoperative third month. Correlation analysis also indicated that ΔNLR was positively correlated with ΔGLS (r = 0.385, P < 0.001), and ΔNOSE (r = 0.436, P < 0.001), and correlated negatively with the ΔMPV (r = -0.302, P = 0.024). ΔGLS was also positively correlated with the ΔNOSE (r = 0.769, P < 0.001). CONCLUSION Septoplasty for MNSD could provide not only alleviation of otorhinolaryngologic symptoms but also improvement in subclinical left ventricular systolic dysfunction and decline in MPV and NLR levels.
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Affiliation(s)
- Mehmet Karataş
- Department of Otorhinolaryngology, Adiyaman University Medical School, Adiyaman
| | - Hakan Taşolar
- Department of Cardiology, Inonu University Medical School, Malatya, Turkey
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Investigation of Blood Characteristics in Nonsyndromic Retinitis Pigmentosa: A Retrospective Study. J Ophthalmol 2019; 2019:1902915. [PMID: 31191992 PMCID: PMC6525908 DOI: 10.1155/2019/1902915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/10/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the characteristics of blood in nonsyndromic retinitis pigmentosa (RP) and reveal the pathogenesis of blood cells involved in blood stasis in RP. Design This is a retrospective observational study. Methods We collected vein blood from 101 cases of patients with nonsyndromic RP and 120 cases of normal individuals according to a single-blind study and used routine clinical examination to detect the indicators of blood. All the subjects were mainly from the central south of China. Data were analyzed statistically between the RP group and normal control. Results The indicator of platelet distribution width (PDW) in patients with RP was higher than that in the normal group; the indicators of red blood cell (RBCs), hemoglobin (HGB), hematocrit (HCT), basophils (BASs), platelets (PLTs), and plateletcrit (PCT) in the RP group were lower than those in the normal control. The differences were statistically very significant between the RP group and normal group (p < 0.01). There were no statistical differences in the other indicators between the RP and normal group. Conclusions The changes in RBCs and PLTs in patients with RP implied that RP induces RBC aggregation and platelet activation, leading to blood stasis which in turn initiates more apoptosis.
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Braschi A. Acute exercise-induced changes in hemostatic and fibrinolytic properties: analogies, similarities, and differences between normotensive subjects and patients with essential hypertension. Platelets 2019; 30:675-689. [DOI: 10.1080/09537104.2019.1615611] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Complete blood count-derived inflammatory markers in adolescents with primary arterial hypertension: a preliminary report. Cent Eur J Immunol 2018; 43:434-441. [PMID: 30799992 PMCID: PMC6384429 DOI: 10.5114/ceji.2018.81353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Aim of the study The aim of our study was to evaluate selected inflammatory markers in children with untreated primary hypertension and to establish the relation between inflammatory markers and 24-hour ambulatory blood pressure monitoring (ABPM) and clinical and biochemical parameters. Material and methods In 54 children (15.12 ±2.02 years) with untreated primary hypertension, with excluded overt inflammation, we evaluated: neutrophils (NEU; 1000/μl), lymphocytes (LYM; 1000/μl), platelets (PLT; 1000/μl), mean platelet volume (MPV; fl), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), ABPM (OSCAR 2 SUNTECH), and selected clinical and biochemical parameters. The control group consisted of 20 healthy children (15.55 ±2.27 years). Results Children with primary hypertension had (p < 0.01) higher 24-hour systolic, diastolic and mean blood pressure, systolic and diastolic blood pressure loads, and pulse pressure. Hypertensive children did not differ in inflammatory indicators (NEU, LYM, PLT, MPV, NLR, PLR) from the control group. In 54 hypertensive children we found the following correlations: between office systolic and diastolic blood pressure and MPV (r = 0.35, p = 0.011, r = 0.36, p = 0.008), between 24-hour ambulatory mean arterial pressure Z-score and NLR (r = 0.30, p = 0.030), 24-hour systolic blood pressure load and NLR (r = 0.38, p = 0.005), plasma renin activity and neutrophil count, NLR, PLR (r = 0.47, p = 0.016, r = 0.64, p < 0.001, r = 0.42, p = 0.033), urinary albumin loss and neutrophil count, NLR (r = 0.46, p = 0.001 and r = 0.42, p = 0.003). Multivariate analysis revealed that office SBP Z-score was related to MPV (β = 0.35, p = 0.008) and albuminuria to neutrophil count (β = 0.62, p = 0.018). Conclusions In children with primary arterial hypertension there may be a relation between blood pressure, urinary albumin loss, and subclinical inflammation.
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Lin WY, Lu X, Fan FJ, Hu Y. Predictive Effect of Mean Platelet Volume in Patients with Portal Vein Thrombosis: A Meta-analysis of Case-control Studies. Curr Med Sci 2018; 38:575-581. [DOI: 10.1007/s11596-018-1916-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 05/28/2018] [Indexed: 12/12/2022]
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Jiang P, Song Y, Xu JJ, Wang HH, Jiang L, Zhao W, Zhao XY, Chen J, Gao Z, Qiao SB, Yang YJ, Gao RL, Xu B, Yuan JQ. Two-year prognostic value of mean platelet volume in patients with diabetes and stable coronary artery disease undergoing elective percutaneous coronary intervention. Cardiol J 2018; 26:138-146. [PMID: 30009376 DOI: 10.5603/cj.a2018.0071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 07/13/2018] [Accepted: 06/13/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Mean platelet volume (MPV) is a marker of platelet size and activity, and is associated with a poor prognosis of cardiovascular disease. Studies have shown a relationship between diabetes mellitus (DM) and MPV. This study examined the relationship between admission MPV and 2-year cardiac mortality in patients with DM and stable coronary artery disease (SCAD) undergoing elective percutaneous coronary intervention (PCI). METHODS A total of 1389 patients were enrolled and divided into two groups according to MPV as fol- lows: lower MPV (n = 908, MPV ≤ 10.9 fL) and higher MPV (n = 481, MPV > 10.9 fL). RESULTS Body mass index, platelet distribution width, MPV/platelet and glycated hemoglobin (HbA1c) levels were significantly higher in the higher MPV group compared with the lower MPV group (all p < 0.05). The platelet count was significantly lower in the higher MPV group compared with the lower MPV group (p < 0.05). MPV was positively associated with HbA1c and fasting plasma glucose levels (r = 0.073 and 0.061, p = 0.007 and 0.023, respectively) in bivariate correlation analysis. The 2-year cardiac mortality rate was 0.7%, and was significantly lower in the lower MPV group than in the higher MPV group in Kaplan-Meier analysis (p = 0.019). Receiver operating characteristic analysis showed a good diagnostic value for MPV at predicting long-term cardiac mortality (area under the curve: 0.735, 95% confidence interval [CI]: 0.590-0.880, p = 0.01). Elevated MPV was a significant risk factor for 2-year cardiac mortality (hazard ratio: 2.091, 95% CI: 1.075-4.070, p = 0.030) in multivariable Cox regression analysis. CONCLUSIONS Mean platelet volume is a strong, independent prognostic factor in PCI-treated patients with DM and SCAD.
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Affiliation(s)
- Ping Jiang
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ying Song
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing-Jing Xu
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huan-Huan Wang
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lin Jiang
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Zhao
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xue-Yan Zhao
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jue Chen
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zhan Gao
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu-Bin Qiao
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yue-Jin Yang
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Run-Lin Gao
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Xu
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin-Qing Yuan
- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Gokdemir MT, Gokdemir GS, Taş M. The association between mean platelet volume and inflammation in geriatric patients with emergency hypertension. Turk J Emerg Med 2018; 19:16-20. [PMID: 30793060 PMCID: PMC6370900 DOI: 10.1016/j.tjem.2018.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/10/2018] [Accepted: 03/14/2018] [Indexed: 11/26/2022] Open
Abstract
Objectives We aimed to investigate the role of inflammation parameters and platelet activation in geriatric patients with hypertension. Therefore, we compared the levels of those parameters in patients with hypertensive urgency and emergency. We also investigated the potential relationship between those parameters. Methods Ninety-six hypertensive (HT) patients (aged > 60) were included in the study in two groups: HT emergency (N = 48, group 1) and HT urgency (N = 48, group 2). Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and high-sensitive C reactive protein (hs-CRP) were compared between those groups. Optimum cut-off levels of each parameter were determined by the use of Receiver operating characteristic (ROC) curve analysis. Pearson correlation test was used to examine the relationship between variables. Results The mean MPV and hs-CRP levels were significantly higher in patients with HT emergencies (both P < 0.001). Mean NLR was also significantly different between the two groups (P = 0.011). Pearson correlation analysis revealed a positive but weak correlation between the MPV and NLR (r = 0.245, P = 0.016), the hs-CRP level (r = 0.394, P < 0.001), and the WBC count (r = 0.362, P < 0.001). Conclusion Increased platelet activity and inflammation are associated with the end organ failure. Levels of MPV and other inflammatory parameters may be useful in the management of geriatric patients with HT.
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Affiliation(s)
- Mehmet Tahir Gokdemir
- Health Sciences University, Gazi Yasargil Research and Training Hospital, Emergency Department, Diyarbakir, Turkey
| | - Gul Sahika Gokdemir
- Dicle University, School of Medicine, Department of Physiology, Diyarbakir, Turkey
| | - Mahmut Taş
- Health Sciences University, Gazi Yasargil Research and Training Hospital, Emergency Department, Diyarbakir, Turkey
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25
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Less primary fistula failure in hypertensive patients. J Hum Hypertens 2018; 32:311-318. [PMID: 29581557 DOI: 10.1038/s41371-018-0052-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 01/28/2018] [Accepted: 02/05/2018] [Indexed: 11/08/2022]
Abstract
End stage renal disease (ESRD) patients suffer from advanced renal diseases and actually nonfunctioning kidneys, and need kidney transplantation or dialysis. Hemodialysis (HD) is the most used method and requires a vascular access (VA). Arteriovenous fistula (AVF) is the first choice of VA over the world for having least morbidity and mortality. Despite the wide-spread use of AVFs, the rate of AVF failures are notable. Detecting the factors that cause AVF failure can reduce repeating VA surgeries and hospitalization of ESRD patients. Present research studies 480 Iranian HD patients who underwent AVF surgery from 2010 to 2017 and aged 18-90 years old, using data mining techniques. (i) The AVF failure rate was equal to 8.96%, such that AVF failure has occurred in 3.54% and 5.52% of HD patient with and without hypertension, respectively. (ii) The rate of non-failure AVF in hypertensive patients is 61.46%, whereas the same rate for patients with negative history of hypertension reaches to 29.58%. (iii) Hypertension has a significant inverse association with AVF failure (Spearman's ρ = -0.160, P-value ≤ 0.005). (iv) The decision tree (with accuracy rate = 92.24%) shows less AVF failure in hypertsensive patients (5.53%) comparing with non-hypertensive patients (15.09%). (v) The AVFs with greater failure rates and non-hypertensive HD patients were clustered together. "Significantly lower risk of AVF failure was associated with presence of a positive history of hypertension; in other words, positive history of hypertension has an adverse effect on AVF failure and Hypertensive HD patients have more maturated AVF."
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26
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Chen G, Bliden KP, Chaudhary R, Liu F, Kaza H, Navarese EP, Tantry US, Gurbel PA. Central aortic pulse pressure, thrombogenicity and cardiovascular risk. J Thromb Thrombolysis 2017; 44:223-233. [PMID: 28695310 DOI: 10.1007/s11239-017-1524-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
High central aortic pulse pressure (CPP) and thrombin-induced platelet-fibrin clot strength (TIP-FCS) have been associated with ischemic outcomes in patients with coronary artery disease in separate studies. But, the ischemic risk associated with these factors has never been analyzed in a single study and their interrelation is unknown. The primary aim of the study was to establish cut points for CPP and TIP-FCS measured at the time of catheterization associated with long term major adverse cardiovascular events. We enrolled 334 consecutive patients undergoing cardiac catheterization and assessed thrombogenicity by thrombelastography. Patients were followed up to 3 years. The primary endpoint was a composite of cardiovascular death, myocardial infarction, and ischemic stroke and the secondary endpoint was occurrence of the primary endpoint or recurrent ischemic events requiring hospitalization. Patients with primary and secondary endpoint occurrence had higher CPP (83 ± 20 vs. 60 ± 18 mmHg, p < 0.0001; 70 ± 21 vs. 59 ± 18 mmHg, p < 0.0001, respectively) and TIP-FCS (68.5 ± 5.8 vs. 65.5 ± 5.0 mm, p = 0.008; 67.4 ± 5.9 vs. 65.2 ± 4.8 mm, p = 0.001, respectively). CPP >60 mmHg and TIP-FCS >69 mm were both independent predictors of primary endpoint occurrence (p = 0.0001 and p = 0.02, respectively). ROC analysis for CPP and TIP-FCS showed a C-statistic of 0.81 (p < 0.0001) and 0.68 (p = 0.007) for the primary endpoint, respectively. Patients with CPP >60 mmHg had higher TIP-FCS (66.8 ± 5.1 vs. 64.8 ± 5.0 mm, p < 0.001) and primary and secondary endpoint occurrence (13 vs. 1.1%, p < 0.0001 and 31.8 vs. 14.4%, p = 0.0002, respectively). CPP >60 mmHg + TIP-FCS > 69 mm was associated with a markedly increased risk of primary endpoint occurrence [HR (95% CI) 5.4(2.3-12.5), p = 0.0001]. High CPP and thrombogenicity are interrelated; each are independently associated with increased cardiovascular risk; and simultaneous presence markedly enhances risk. The mechanistic link between CPP and thrombogenicity deserves further study.
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Affiliation(s)
- Gailing Chen
- Sinai Center for Thrombosis Research, Sinai Hospital, Baltimore, MD, USA.,Department of Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Kevin P Bliden
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, 3300 Gallows Rd, Fairfax, VA, USA
| | - Rahul Chaudhary
- Division of Medicine, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Fang Liu
- Sinai Center for Thrombosis Research, Sinai Hospital, Baltimore, MD, USA.,Department of Neurology, Beijing Hospital, Beijing, China
| | - Himabindu Kaza
- Sinai Center for Thrombosis Research, Sinai Hospital, Baltimore, MD, USA
| | - Eliano P Navarese
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, 3300 Gallows Rd, Fairfax, VA, USA
| | - Udaya S Tantry
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, 3300 Gallows Rd, Fairfax, VA, USA
| | - Paul A Gurbel
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, 3300 Gallows Rd, Fairfax, VA, USA.
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27
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Lau YC, Xiong Q, Blann AD, Lip GYH. Relationship between renal function and circulating microparticles, soluble P-selectin and E-selectin levels in atrial fibrillation. J Thromb Thrombolysis 2017; 43:18-23. [PMID: 27671694 PMCID: PMC5233739 DOI: 10.1007/s11239-016-1427-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Atrial fibrillation (AF) and chronic kidney disease are closely related, and any associated risk of stroke and thromboembolism due to AF is increased by concurrent renal dysfunction. The mechanism(s) for this include abnormalities in platelets and endothelial cells. We hypothesized relationships between levels of circulating platelet microparticles (PMPs, defined by CD42b), soluble P selectin (both reflecting platelet activation), soluble E-selectin (reflecting endothelial activation) and endothelial/platelet microparticles (EPMPs, defined by CD31) with progressive renal dysfunction. Blood samples were obtained from 160 anticoagulated AF patients. Microparticles were measured by flow cytometry, soluble E and P selectin levels by ELISA. Renal function was determined by estimated glomerular filtration rate (eGFR). EPMP levels demonstrated a linear increased trend across quartiles of eGFR (p = 0.034) and CKD stage (p < 0.001), and correlated with eGFR and serum creatinine (p < 0.01). PMPs, P-selectin and E-selectin levels were not significantly different across groupings of renal dysfunction, and no significant correlations with eGFR were evident (p = 0.186, p = 0.561, p = 0.746 respectively). Stepwise multivariable regression analysis demonstrated that worsening renal function was an independent predictor of EPMP levels (p < 0.001). In well-anticoagulated AF patients, there is potential relationship between endothelial function (as judged by elevated EPMP levels, with no change in PMPs) and renal function. Other markers of prothombotic state or cellular activation (PMP, P-selectin and E-selectin levels) were not significantly different across the various degree of renal dysfunction. Renal function must be addressed when measuring EPMP levels.
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Affiliation(s)
- Yee Cheng Lau
- University of Birmingham Institute of Cardiovascular Science, City Hospital, Dudley Road, Birmingham, UK
| | - Qinmei Xiong
- University of Birmingham Institute of Cardiovascular Science, City Hospital, Dudley Road, Birmingham, UK.,Cardiovascular Department, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Andrew D Blann
- University of Birmingham Institute of Cardiovascular Science, City Hospital, Dudley Road, Birmingham, UK
| | - Gregory Y H Lip
- University of Birmingham Institute of Cardiovascular Science, City Hospital, Dudley Road, Birmingham, UK.
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28
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Changes at Mean Platelet Volume and Platelet Distribution Width Levels After Septoplasty and Its Correlation With Epworth Sleepness Scale. J Craniofac Surg 2017; 28:71-73. [PMID: 27893555 DOI: 10.1097/scs.0000000000003207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Nasal septum deviation may affect cardiopulmonary system. Those effects can be determined via blood tests and Epworth sleepness scale (ESS). In this study, it was aimed to measure mean platelet volume (MPV) and platelet distribution width (PDW) in patients with nasal septum deviation and to assess changes at their levels after septoplasty. Furthermore, it was purposed to document the correlation between ESS score and MPV, PDW levels. METHODS Eighty-one patients who underwent septoplasty and 50 healthy controls composed the study group. Epworth sleepness scale was performed to all patients preoperatively and patients were divided into 2 groups in terms of ESS scores. Mean platelet volume and PDW levels were measured preoperatively and it was repeated postoperatively. RESULTS In Group A (ESS <10), MPV reduced from 8.48 ± 0.38 fl to 8.47 ± 0.36 fl (P >0.05), PDW reduced from 14.56 ± 1.27% to 14.43 ± 1.03% after surgery (P >0.05). On the other hand, in Group B (ESS ≥10), MPV reduced from 9.54 ± 0.68 fl to 8.87 ± 0.44 fl (P <0.001), PDW reduced from 17.15 ± 1.75% to 15.35 ± 1.29% postoperatively (P <0.001). CONCLUSIONS Statistically significant improvements at MPV and PDW levels after surgery were noticed only at patients with excessive daytime sleepness whose ESS score was 10 or above. According to this, it would be preferable to operate these patients earlier to protect them from systemic effects.
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29
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Ates I, Bulut M, Ozkayar N, Dede F. Association between high platelet indices and proteinuria in patients with hypertension. Ann Lab Med 2016; 35:630-4. [PMID: 26354352 PMCID: PMC4579108 DOI: 10.3343/alm.2015.35.6.630] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 05/13/2015] [Accepted: 08/03/2015] [Indexed: 11/19/2022] Open
Abstract
Background We aimed to determine the association between platelet indices including plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW), and proteinuria associated with hypertension (HT) as well as the relative power of each to predict proteinuria. Methods The study included 223 patients (68 men and 155 women) with primary HT. PCT, MPV, PDW, and proteinuria levels were measured. The patients were divided into two groups according to proteinuria status based on 24-hr urinary protein excretion: proteinuria (+) group (15 men and 40 women) and proteinuria (-) group (53 men and 115 women). Results The mean and SD of platelet count, PDW, PCT, and MPV were 278.8±49.6×109/L, 13.5±1.8%, 0.31±0.07%, and 11.3±2.6 fL, respectively. The mean platelet count, PCT, MPV, and PDW were significantly higher in the proteinuria (+) group than in the proteinuria (-) group (P<0.05); there were no significant differences in the other blood parameters between the two groups. The platelet count, PCT, MPV, and PDW were independent risk factors predictive of proteinuria according to a stepwise regression analysis of PDW, PCT, and MPV. PCT was the strongest independent predictor of proteinuria. Conclusions The platelet indices PCT, PDW, and MPV were significantly higher in patients with proteinuria than in those without it. Among these three indices, PCT was the strongest predictor of proteinuria.
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Affiliation(s)
- Ihsan Ates
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Mesudiye Bulut
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
| | - Nihal Ozkayar
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey.
| | - Fatih Dede
- Ankara Numune Education and Research Hospital, Department of Nephrology, Ankara, Turkey
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30
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Ahbap E, Sakaci T, Kara E, Sahutoglu T, Koc Y, Basturk T, Sevinc M, Akgol C, Hasbal B, Isleem M, Nazif P, Caglayan FB, Unsal A. Serum uric acid levels and inflammatory markers with respect to dipping status: A retrospective analysis of hypertensive patients with or without chronic kidney disease. Clin Exp Hypertens 2016; 38:555-63. [PMID: 27392197 DOI: 10.3109/10641963.2016.1174251] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The aim of this study was to evaluate serum uric acid levels, inflammatory markers [C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR)] and mean platelet volume (MPV) among hypertensive patients with or without chronic kidney disease (CKD) with respect to dipping status. METHODS A total of 432 hypertensive patients with (n = 340) or without (n = 92) CKD who had ambulatory blood pressure monitoring recordings were included. Correlation of serum uric acid levels with inflammatory markers (CRP, PLR, NLR) was evaluated as was the logistic regression analysis for determinants of nondipper pattern. RESULTS Nondipper pattern was noted in 65.2% and 79.7% of non-CKD and CKD patients, respectively. Multivariate logistic regression analysis revealed that only serum uric acid (OR, 2.69; 95% CI, 1.60 to 4.52; p = 0.000), MPV (OR, 1.81; 95% CI, 1.30 to 2.53; p = 0.000), PLR (OR, 0.98; 95% CI, 0.97 to 0.99; p = 0.000), and serum albumin (OR, 0.42; 95% CI, 0.19 to 0.93; p = 0.031) were significant determinants of nondipper pattern in the overall study population. CONCLUSION In conclusion, our findings revealed higher prevalence of nondipper pattern in hypertensive patients with than without CKD and significantly higher levels for uric acid, CRP, MPV, PLR, and NLR among nondipper than dipper hypertensive patients with CKD. High levels for uric acid and MPV and lower levels for PLR and serum albumin were noted as significant determinants of nondipper pattern among hypertensive patients.
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Affiliation(s)
- Elbis Ahbap
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Tamer Sakaci
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Ekrem Kara
- b Department of Internal Medicine, Division of Nephrology , RecepTayyip Erdogan University Faculty of Medicine , Rize , Turkey
| | - Tuncay Sahutoglu
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Yener Koc
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Taner Basturk
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Mustafa Sevinc
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Cuneyt Akgol
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Barıs Hasbal
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Mahmoud Isleem
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | - Perin Nazif
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
| | | | - Abdulkadir Unsal
- a Department of Nephrology , Sisli Etfal Training and Research Hospital , Istanbul , Turkey
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31
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Akin MN, Kasap B, Yuvaci HU, Turhan N. Association between platelet indices and first trimester miscarriage. Blood Coagul Fibrinolysis 2016; 27:526-30. [DOI: 10.1097/mbc.0000000000000445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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32
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Sansanayudh N, Muntham D, Yamwong S, Sritara P, Akrawichien T, Thakkinstian A. The association between mean platelet volume and cardiovascular risk factors. Eur J Intern Med 2016; 30:37-42. [PMID: 26777606 DOI: 10.1016/j.ejim.2015.11.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 10/21/2015] [Accepted: 11/30/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) correlates with platelet activation and has recently emerged as a potential marker of cardiovascular diseases. Previous publications also suggest possible association between MPV and some cardiovascular risk factors but the evidences are still conflicting and inconclusive. OBJECTIVE To study the association between MPV and cardiovascular risk factors. METHODS This is a cross-sectional study using data from the second survey of the Electricity Generating Authority of Thailand (EGAT) cohort. All participants of the survey who had results of MPV were included. Exclusion criteria included subjects with known hematologic disease or subjects with hematocrit <30% or platelet count <140,000/mm(3). The details of cardiovascular risk factors were documented and the association between MPV and risk factors was analyzed using fractional polynomial regression analysis. RESULTS There were 2727 subjects with MPV results. After excluding those who had hematologic disease, 2642 subjects were included for analysis. Univariate analysis revealed that gender, diabetes, serum triglyceride, hypertension, and prehypertension were associated with MPV. Hematocrit, platelet count and fasting plasma glucose were inversely correlated with MPV. After adjusting with other variables, the risk factors that remained significantly associated with MPV included female gender, diabetes, metabolic syndrome, serum triglyceride, hypertension, and prehypertension. Platelet count and hematocrit were found to have significant inverse correlation with MPV. CONCLUSION After adjusting for other cardiovascular risk factors, the independent factors remain associated with MPV included female gender, diabetes, metabolic syndrome, serum triglyceride, hypertension and prehypertension. MPV has significant, but inverse association with platelet count and hematocrit.
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Affiliation(s)
- Nakarin Sansanayudh
- Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
| | - Dittapol Muntham
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
| | - Sukit Yamwong
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
| | - Piyamitr Sritara
- Division of Cardiology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand.
| | | | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Liu G, Liang B, Song X, Bai R, Qin W, Sun X, Lu Y, Bian Y, Xiao C. P‑selectin increases angiotensin II‑induced cardiac inflammation and fibrosis via platelet activation. Mol Med Rep 2016; 13:5021-8. [PMID: 27121797 PMCID: PMC4878563 DOI: 10.3892/mmr.2016.5186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 03/31/2016] [Indexed: 01/19/2023] Open
Abstract
Platelet activation is important in hypertension-induced cardiac inflammation and fibrosis. P-selectin expression significantly (P<0.05) increases when platelets are activated during hypertension. Although P-selectin recruits leukocytes to sites of inflammation, the role of P-selectin in cardiac inflammation and fibrosis remains to be elucidated. The present study aimed to investigate whether platelet-derived P-selectin promotes hypertensive cardiac inflammation and fibrosis. P-selectin knockout (P-sel KO) mice and wild-type (WT) C57BL/6 littermates were infused with angiotensin II (Ang II) at 1,500 ng/kg/min for 7 days and then cross-transplanted with platelets originating from either WT or P-sel KO mice. P-selectin expression was increased in the myocardium and plasma of hypertensive mice, and the P-sel KO mice exhibited significantly (P<0.05) reduced cardiac fibrosis. The fibrotic areas were markedly smaller in the hearts of P-sel KO mice compared with WT mice, as assessed by Masson's trichrome staining. In addition, α-smooth muscle actin and transforming growth factor β1 (TGF-β1) expression levels were decreased in the P-sel KO mice, as assessed by immunohistochemistry. Following platelet transplantation into P-sel KO mice, the number of Mac-2 (galectin-3)- and TGF-β1-positive cells was increased in mice that received WT platelets compared with those that received P-sel KO platelets, and the mRNA expression levels of collagen I and TGF-β1 were also increased. The results from the present study suggest that activated platelets secrete P-selectin to promote cardiac inflammation and fibrosis in Ang II-induced hypertension.
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Affiliation(s)
- Gaizhen Liu
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Bin Liang
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Xiaosu Song
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Rui Bai
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Weiwei Qin
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Xu Sun
- Department of Cardiology, Tianjin Port Hospital, Tianjin 300456, P.R. China
| | - Yan Lu
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Yunfei Bian
- Department of Cardiology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
| | - Chuanshi Xiao
- Department of Cardiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, P.R. China
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Işık H, Alptekin H, Selimoğlu R, Cengiz T, Kucukapan HU, Alptekin N. Anticoagulant Therapy in Primary and Secondary Recurrent Pregnancy Losses with Hereditary Thrombophilia and Perinatal Outcomes. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2016. [DOI: 10.5799/jcei.328667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Sun XP, Li BY, Li J, Zhu WW, Hua Q. Impact of Mean Platelet Volume on Long-Term Mortality in Chinese Patients with ST-Elevation Myocardial Infarction. Sci Rep 2016; 6:21350. [PMID: 26879002 PMCID: PMC4754908 DOI: 10.1038/srep21350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/22/2016] [Indexed: 11/28/2022] Open
Abstract
We investigated the association between mean platelet volume (MPV) and risk of all-cause mortality in Chinese patients with ST-Elevation Myocardial Infarction (STEMI). We enrolled 1836 patients with STEMI in Xuanwu Hospital from January 2008 to December 2013. Based on MPV, patients were categorized into the following groups: <9.5 fL (n = 85), 9.5–11.0 fL (n = 776), 11.1–12.5 fL (n = 811) and >12.5 fL (n = 164), respectively. Mean duration of follow-up was 56.9 months, and 197 patients (10.7%) died during follow-up. All-cause mortality rates were compared between groups. The lowest mortality occurred in patients with MPV between 9.5–11.0 fL, with a multivariable-adjusted hazard ratio (HR) of 1.15(95%CI 0.62–1.50), 1.38(95%CI 1.20–1.68), and 1.72(95%CI 1.41–1.96) in patients with MPV of <.5, 11.1–12.5 and >12.5 fL, respectively. Therefore, increased MPV was associated with all-cause mortality in Chinese patients with STEMI. MPV might be useful as a marker for risk stratification in Chinese patients with STEMI.
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Affiliation(s)
- Xi-peng Sun
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
| | - Bo-yu Li
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
| | - Jing Li
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
| | - Wei-wei Zhu
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
| | - Qi Hua
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, China, 100053
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Karabacak M, Yiğit M, Turkdogan KA, Yiğit E, Selek S. Is signal peptide-CUB-EGF domain-containing protein1 a diagnostic biomarker in patients with hypertensive crises. Clin Hemorheol Microcirc 2016; 61:513-22. [PMID: 25536916 DOI: 10.3233/ch-141917] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Mehmet Yiğit
- Department of Emergency Medicine, Bezimialem Foundation University, Istanbul, Turkey
| | - Kenan Ahmet Turkdogan
- Department of Emergency Medicine, Bezimialem Foundation University, Istanbul, Turkey
| | - Eda Yiğit
- Department of Emergency Medicine, Bezimialem Foundation University, Istanbul, Turkey
| | - Sehabettin Selek
- Department of Biochemistry, Bezmialem Foundation University, Istanbul, Turkey
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de Faria AP, Ritter AMV, Sabbatini AR, Corrêa NB, Brunelli V, Modolo R, Moreno H. Deregulation of Soluble Adhesion Molecules in Resistant Hypertension and Its Role in Cardiovascular Remodeling. Circ J 2016; 80:1196-201. [DOI: 10.1253/circj.cj-16-0058] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Ana Paula de Faria
- Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas
| | | | | | - Nathália Batista Corrêa
- Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas
| | - Veridiana Brunelli
- Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas
| | - Rodrigo Modolo
- Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas
| | - Heitor Moreno
- Laboratory of Cardiovascular Pharmacology, Faculty of Medical Sciences, University of Campinas
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Bhatti AB, Ali F, Satti SA. Relationship of Hypertensive Retinopathy with Mean Platelet Volume Among Hypertensive Patients. Cureus 2015; 7:e422. [PMID: 26835193 PMCID: PMC4726072 DOI: 10.7759/cureus.422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background
The pathophysiological mechanism of hypertensive retinopathy (HR) is not fully understood, although it is thought that increased platelet activation may have a pivotal role. This study was designed to investigate this possibility by determining the frequency and magnitude of mean platelet volume (MPV), a marker of platelet activation, in HR. Methods
One hundred and thirty-eight patients, aged 31 to 80 years, who had essential hypertension with HR were enrolled in the study. The patients who presented at the emergency and outpatient medical department of the Capital Development Authority (CDA) Hospital, Islamabad, Pakistan, from March 2013 to February 2014 were selected for this study. All patients were analyzed for grading of HR according to the Keith-Wagener-Barker (KWB) classification criteria. A direct ophthalmoscopic examination was performed in all the subjects, together with an assessment of MPV. Results
The mean age of the patients was 54.1 ± 11.7 years. Normal MPV was found in 97 (70.2%) patients, 53 males and 44 females. Elevated levels of MPV were found in 41 (29.7%) patients, 19 males and 22 females. In patients with Grade 1 HR, the MPV was 10.6 ± 0.6 femtoliters (fl). In Grades 2, 3, and 4 HR, the values of MPV were 11.1± 0.5 fl, 11.6 ± 0.3 fl, and 12.2 ± 0.6 fl, respectively, which were greater than the normal range (> 10 fl) of MPV values. In addition, the frequency of elevated MPV significantly (P < 0.001) and linearly (r = 0.998) increased with increasing HR grade. Conclusion
It is concluded that the frequency of elevated MPV is increased in patients with HR and strongly correlates to grade. In addition, the magnitude of the elevated MPV increased with the severity of the retinopathy. Thus, abnormally elevated MPV may be an etiological factor for HR in hypertensive patients.
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Affiliation(s)
- Adnan Bashir Bhatti
- Department of Medicine, Capital Development Authority Hospital, Islamabad, Pakistan
| | - Farhan Ali
- Department of Medicine, Capital Development Authority Hospital, Islamabad, Pakistan
| | - Siddique Akbar Satti
- Department of Medicine, Capital Development Authority Hospital, Islamabad, Pakistan
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Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P, Thakkinstian A. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost 2015; 114:1299-309. [PMID: 26245769 DOI: 10.1160/th15-04-0280] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/17/2015] [Indexed: 12/22/2022]
Abstract
Large platelets with high haemostatic activity may lead to increased platelet aggregation.. Mean platelet volume (MPV), an indicator of platelet reactivity, may emerge as a prognostic marker in patients with coronary artery disease (CAD). It was the objective of this study to conduct a systematic review and meta-analysis to assess prognostic effects of MPV on cardiovascular events (CVE) in CAD patients. We searched MEDLINE and SCOPUS from inception to January 2, 2014. All studies that reported MPV and the incidence of cardiovascular events in CAD patients were included. Two reviewers independently extracted the data. A random-effects model was applied for pooling the mean difference of MPV between patients with vs without CVE. Among 30 eligible studies, eight studies reported mean difference of MPV between CVE groups, 11 studies reported MPV dichotomous into high vs low MPV groups, and 11 studies reported both. The pooled mean difference was 0.69 fL (95 %CI = 0.36, 1.01), i. e. patients with CVE had a MPV about 0.69 fL higher than non-CVE. Patients with higher MPV were about 12 % more likely to die than patients with lower MPV (RR 1.12; 95 %CI = 1.02-1.24). However, pooling these effects was based on high heterogeneity and the source of heterogeneity could not be identified. This might be explained by many differences among included studies (e. g. study population, outcomes of interest, analysate, time between blood collection and MPV analysis, etc). These findings suggest that MPV may be a useful prognostic marker in patients with CAD.
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Affiliation(s)
| | - Pawin Numthavaj
- Pawin Numthavaj, MD, Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 370 Rama VI road, Rajathevi, 10400 Bangkok, Thailand, Tel.: 6622011284, Fax: 6622011284, E-mail:
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Verdoia M, Pergolini P, Rolla R, Nardin M, Barbieri L, Schaffer A, Bellomo G, Marino P, Suryapranata H, De Luca G. Mean platelet volume and high-residual platelet reactivity in patients receiving dual antiplatelet therapy with clopidogrel or ticagrelor. Expert Opin Pharmacother 2015; 16:1739-47. [PMID: 26067422 DOI: 10.1517/14656566.2015.1056151] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE High on-treatment platelet reactivity (HRPR) is associated with a two- to ninefold increased risk of recurrent ischemic events among patients receiving dual antiplatelet therapy (DAPT) for coronary artery disease. However, its determinants are still poorly understood. The aim of the present study was to assess the impact of mean platelet volume (MPV) on platelet reactivity in patients receiving DAPT after an acute coronary syndrome or PCI. METHODS Patients treated with DAPT (acetylsalicylic acid [ASA] and clopidogrel or ticagrelor) were scheduled for platelet function assessment at 30 - 90 days post-discharge. By whole blood impedance aggregometry, HRPR was considered for ASPI test > 862 aggregation units (AU)*min (for ASA) and ADP test values ≥ 417 AU*min (for ADP-antagonists). RESULTS Our population is represented by a total of 487 patients on DAPT, divided according to MPV tertiles (< 10.4 fl; 10.4 - 11.29 fl; ≥ 11.3 fl). Larger-sized platelets were associated with use of statins (p < 0.001) and beta-blockers (p = 0.03), higher hemoglobin levels (p = 0.002) and lower platelets count (p < 0.001). Higher platelet reactivity was observed at ASPI test in patients with higher MPV (r = 0.12, p = 0.008), but not for ADP-mediated aggregation (r = -0.007, p = 0.88). However, a low prevalence of HRPR was observed with ASA, with no impact of MPV tertiles (1.2 vs 1.1 vs 1.6%, p = 0.70, adjusted OR [95% CI] = 1.05 [0.51 - 1.77], p = 0.87). MPV did not influence the prevalence of HRPR for ADP-antagonists (25.9 vs 1 vs 26.5%, p = 0.89; adjusted OR [95% CI] = 1.1 [0.84 - 1.45], p = 0.50) with similar results among the 259 patients receiving clopidogrel (adjusted OR [95% CI] = 1.15 [0.82 - 1.62], p = 0.43) and the 228 patients on ticagrelor (adjusted OR [95% CI] = 1.46 [0.84 - 2.55], p = 0.18). CONCLUSION In patients receiving DAPT, MPV does not affect the response to major antiplatelet therapies. In fact, MPV elevation does not influence the risk of HRPR with clopidogrel, ticagrelor or ASA.
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Affiliation(s)
- Monica Verdoia
- Eastern Piedmont University, Ospedale 'Maggiore della Carità', Department of Cardiology , C.so Mazzini, 18 28100 Novara , Italy +39 0321 3733141 ; +39 0321 3733407 ;
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Bilen Y, Çankaya E, Keleş M, Uyanık A, Aydınlı B, Bilen N. High-Grade Inflammation in Renal Failure Patients, According to Mean Platelet Volume, Improves at the End of Two Years After Transplantation. Transplant Proc 2015; 47:1373-6. [DOI: 10.1016/j.transproceed.2015.04.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Surgit O, Pusuroglu H, Erturk M, Akgul O, Buturak A, Akkaya E, Gul M, Uygur B, Yazan S, Eksik A. Assessment of Mean Platelet Volume in Patients with Resistant Hypertension, Controlled Hypertension and Normotensives. Eurasian J Med 2015; 47:79-84. [PMID: 26180490 PMCID: PMC4494555 DOI: 10.5152/eurasianjmed.2015.43] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 07/24/2014] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE Patients with resistant hypertension are at increased risk for cardiovascular events. Mean platelet volume (MPV) is an accepted biomarker of platelet activation and considered as a risk factor for cardiovascular disease. The aim of this study was to determine whether MPV levels are higher in resistant hypertensive (RHTN) patients than in controlled hypertensive (CHTN) patients and healthy normotensive controls. MATERIALS AND METHODS 279 consecutive patients were included in this study. Patients were divided into three groups: Resistant hypertension patient group [n=78; mean age 56.8±9.8; 42 males (53.8%)]; controlled hypertension patient group [n=121; mean age 54.1±9.6; 49 males (40.5%)]; and normotensive control group [n=80; mean age 49.8±8.5; 34 males (42.5%)]. Physical examination, laboratory work-up, and 24-hour ambulatory blood pressure measurement (ABPM) were performed in all participants. RESULTS The mean platelet volume levels were significantly higher in RHTN group than in the CHTN and normotensive groups (p<0.001). In correlation analysis office systolic and diastolic blood pressure was positively correlated with MPV. CONCLUSION Our study demonstrated that MPV, as an important indicator of platelet activation, was statistically higher in RHTN patients than in CHTN and in normotensive subjects. Elevated MPV levels may help to determine a high risk group for atherosclerosis in RHTN patients.
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Affiliation(s)
- Ozgur Surgit
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Hamdi Pusuroglu
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Akgul
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ali Buturak
- Department of Cardiology, Acibadem University, Istanbul, Turkey
| | - Emre Akkaya
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Gul
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Begum Uygur
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Serkan Yazan
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Abdurrahman Eksik
- Clinic of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Timasheva YR, Nasibullin TR, Imaeva EB, Erdman VV, Kruzliak P, Tuktarova IA, Nikolaeva IE, Mustafina OE. Polymorphisms of inflammatory markers and risk of essential hypertension in Tatars from Russia. Clin Exp Hypertens 2015; 37:398-403. [PMID: 25945941 DOI: 10.3109/10641963.2014.987394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Essential hypertension (EH) is a common disease with a clear genetic component. Inflammation and endothelial dysfunction play a prominent role in the development of persistent blood pressure elevation. The aim of the current study was to detect an association between EH and polymorphic markers in genes encoding for molecules involved in the control of intercellular interactions during the inflammation process. We analysed SNPs in SELE, SELP, SELL, ICAM1, VEGFA, IL1B, IL6, IL10 and IL12B genes in a group of 534 men of Tatar ethnicity (217 patients with EH and 317 controls). Using a Markov chain Monte-Carlo-based approach (APSampler), we found genotype and allelic combinations associated with EH. The most significant associations were observed for SELE rs2076059*C-SELP rs6131*A-VEGFA -2549*I-IL1B rs16944*C (p = 3.42 × 10(-5), FDR q = 0.035) and SELE rs2076059*C-SELP rs6131*A-IL12B rs3212227*C-IL1B rs16944*C (p = 323 × 10(-4), FDR q = 0.035).
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Affiliation(s)
- Yanina R Timasheva
- Institute of Biochemistry and Genetics of Ufa Scientific Centre RAS , Pr. Oktyabrya, Ufa , Russian Federation
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Uçar H, Gür M, Gözükara MY, Kıvrak A, Kolcu Z, Akyol S, Kaypaklı O, Elbasan Z, Şahin DY, Türkoğlu C, Şeker T, Çaylı M. Relationship between mean platelet volume and morning blood pressure surge in newly diagnosed hypertensive patients. Anatol J Cardiol 2015; 15:107-12. [PMID: 25252294 PMCID: PMC5336993 DOI: 10.5152/akd.2014.5196] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2014] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Morning blood pressure surge (MBPS) is an independent predictor of atherothrombotic cardiovascular events in hypertensive patients. There is evidence from studies supporting the validity of mean platelet volume (MPV) as a marker of vascular risk and predictor of thrombotic complications. The aim of this study is to investigate the relationship between MPV and MBPS in hypertensive patients. METHODS Measurements were obtained from 298 patients with newly diagnosed essential hypertension (Mean age: 51.9 ± 11.7 years). The patients were divided into two groups (MPV(low) group; <10.8 fL, MPV(high) group; ≥ 10.8 fL). The MBPS was calculated as mean systolic BP during the 2 hours after awaking minus the mean systolic BP during the 1 hour that included the lowest sleep BP. RESULTS MPV was independently associated with MBPS (β=0.554, p<0.001) and hs-CRP level (β=0.286, p<0.001). CONCLUSION Finally, higher MPV values related to enhanced MBPS which are associated with atherothrombotic cardiovascular events.
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Affiliation(s)
- Hakan Uçar
- Clinic of Cardiology, Adana Numune Training and Research Hospital; Adana-Turkey.
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Impact of age on mean platelet volume and its relationship with coronary artery disease: A single-centre cohort study. Exp Gerontol 2015; 62:32-6. [DOI: 10.1016/j.exger.2014.12.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/30/2014] [Accepted: 12/31/2014] [Indexed: 11/17/2022]
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Patkó Z, Szebeni J. Blood cell changes in complement activation-related pseudoallergy. EUROPEAN JOURNAL OF NANOMEDICINE 2015. [DOI: 10.1515/ejnm-2015-0021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractThe characteristic physiological changes in complement (C) activation-related pseudoallergy (CARPA) include thrombocytopenia, leukocytosis and leukopenia with or without compensatory leukocytosis. In the background of these phenomena it is known that anaphylatoxins, the triggers of CARPA, can activate white blood cells (WBCs) and platelets, and that this activation can lead to the binding of these cells to each other and also to capillary endothelial cells, entailing microthrombus formation and circulatory blockage mainly in the pulmonary and coronary microcirculation. These changes are key contributors to the hemodynamic alterations in CARPA, and can lead to anaphylactic shock. The goal of this review was to catalogue the blood cell changes in man and different animals undergoing CARPA and focus on some details of the molecular and cellular interactions among anaphylatoxins, other C activation byproducts, platelets, WBCs (mainly monocytes), macrophages and endothelial cells and these cells’ secretory products during CARPA. By discussing the inhibitors of different steps of the complex interplay between reaction mediators and cell surface receptors, the review might help in identifying possible novel drugs candidates against CARPA.
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Aynıoglu O, Isık H, Sahbaz A, Harma MI, Isık M, Kokturk F. Can Plateletcrit be a Marker for Recurrent Pregnancy Loss? Clin Appl Thromb Hemost 2014; 22:447-52. [DOI: 10.1177/1076029614565882] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Aim: To determine the utility of platelet (PLT) indices for the prediction of recurrent pregnancy loss (RPL). Methods: In all, 208 patients who experienced 2 or more first trimester spontaneous abortions and 95 controls who had no abortions were studied. The hematological markers, including plateletcrit (PCT) and neutrophil (Neu) to lymphocyte (Lym) ratio (NLR), were measured. Thrombophilia genetic tests for factor V Leiden mutation, prothrombin G202I0A mutation, and methylenetetrahydrofolate reductase C677 T and A1298C mutations were performed. Results: The PLT count, PCT, white blood cell count, red cell distribution width (RDW), Lym and Neu count, and NLR were significantly higher in patients with RPL than in controls. The RDW, PLT, and PCT values were higher in the low-risk group, whereas mean PLT volume values were lower than the high-risk group values. Conclusion: Plateletcrit is a low-cost, widely available marker for prediction of RPL in patients with a history of at least 1 abortus.
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Affiliation(s)
- Oner Aynıoglu
- Department of Gynecology and Obstetrics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Hatice Isık
- Department of Gynecology and Obstetrics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Ahmet Sahbaz
- Department of Gynecology and Obstetrics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Mehmet I. Harma
- Department of Gynecology and Obstetrics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Metin Isık
- Department of Romatology, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
| | - Furuzan Kokturk
- Department of Biostatistics, Faculty of Medicine, Bülent Ecevit University, Zonguldak, Turkey
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Han JS, Park KS, Lee MJ, Kim CH, Koo HM, Doh FM, Kim EJ, Han JH, Park JT, Han SH, Yoo TH, Kang SW, Oh HJ. Mean platelet volume is a prognostic factor in patients with acute kidney injury requiring continuous renal replacement therapy. J Crit Care 2014; 29:1016-21. [DOI: 10.1016/j.jcrc.2014.07.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/29/2014] [Accepted: 07/19/2014] [Indexed: 10/25/2022]
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Pusuroglu H, Cakmak HA, Erturk M, Akgul O, Akkaya E, Tosu AR, Celik O, Gul M, Yildirim A. Assessment of the relation between mean platelet volume, non-dipping blood pressure pattern, and left ventricular mass index in sustained hypertension. Med Sci Monit 2014; 20:2020-6. [PMID: 25338525 PMCID: PMC4215576 DOI: 10.12659/msm.891040] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Elevated mean platelet volume may reflect presence of active large platelets, which lead to fatal or non-fatal cardiovascular events. In recent studies, lack of nocturnal blood pressure fall was presented as an independent predictor of poor prognosis in essential hypertension. The relation of raised MPV with left ventricular hypertrophy has also been reported in hypertension. The aim of this study was to investigate the relation between MPV, non-dipping blood pressure pattern, and left ventricular mass index (LVMI) in sustained hypertension. Material/Methods A total of 2500 patients, whose ambulatory blood pressure (ABP) records had been evaluated retrospectively between January 2010 and December 2012, were included. Patients were divided into 3 groups according to their ABP values: non-dipper hypertensive (n=289), dipper hypertensive (n=255), and normotensive (n=306). The MPV levels and biochemical analyses were recorded from patient files and, LVMI were automatically calculated using a regression equation. Results The non-dipper and dipper hypertensive groups had significantly higher MPV levels than normotensives (8.4±1 fL, 8.3±1 fL, and 8.1±0.6 fL, respectively, p<0.001). However, there was no difference among the non-dipper and dipper groups in terms of MPV level (p=0.675). Although LVMI was significantly different between non-dipper, dipper, and normotensive groups (p=0.009), no correlation was found between MPV level and LVMI in dipper and non-dipper hypertensive patients (r=−0.080, p=0.142). There was a weak correlation between MPV level and ambulatory 24-h diastolic and systolic blood pressure (r=0.076, p=0.027, and r=0.073, p=0.033, respectively). Conclusions We demonstrated that there was no correlation between MPV level, non-dipping pattern of blood pressure, and LVMI in sustained hypertension.
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Affiliation(s)
- Hamdi Pusuroglu
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Huseyin A Cakmak
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Erturk
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Akgul
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Emre Akkaya
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aydin Rodi Tosu
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Omer Celik
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Gul
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Aydin Yildirim
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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Combination between mean platelet volume and platelet distribution width to predict the prevalence and extent of coronary artery disease: results from a large cohort study. Blood Coagul Fibrinolysis 2014; 25:86-91. [PMID: 24126247 DOI: 10.1097/mbc.0b013e32836577a8] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the current study was to investigate whether the combination between mean platelet volume (MPV) and platelet distribution width (PDW) may improve the prognostic information in the prediction of prevalence and extent of coronary artery disease (CAD). We measured MPV and PDW in 2330 consecutive patients undergoing coronary angiography. Significant CAD was defined as stenosis more than 50% in at least one coronary vessel. We additionally measured carotid intima-media thickness (IMT) in 359 patients. Patients were grouped according to the median value of MPV (10.8fl) and PDW (13fl): Group 1 (MPV and PDW < 50th percentile; n = 958); Group 2 (MPV or PDW ≥50th percentile; n = 288); Group 3 (MPW and PDW ≥ 50th percentile; n = 1055). Patients in Group 3 were older (P < 0.001) with larger prevalence of diabetes (P = 0.024). Combined MPV-PWD was significantly associated with baseline glycemia (P < 0.001) and red blood cell count (P < 0.0001), but inversely related to platelet count (P < 0.0001). Combined MPV-PDW was inversely associated with the presence of thrombus, but directly related to the prevalence of chronic occlusion and worse TIMI flow. However, combined MPV-MPV was not associated with the prevalence of CAD [odds ratio (OR) (95% confidence interval (CI) = 0.99 (0.90-1.09), P = 0.87; adjusted OR (95%CI) = 0.95 (0.85-1.05), P = 0.3], or severe CAD [OR (95%CI) = 1.05 (0.95-1.16), P = 0.3; adjusted OR (95% CI) = 0.97 (0.87-1.08), P = 0.63]. No relationship was observed between IMT and the combination of PDW and MPW. This study showed that the combined information on MPV and PDW is not related to the extent of CAD and carotid IMT. Thus, both MPV and PDW can not be considered as a risk factor for CAD.
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