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Anjum F, Gilani M, Latif M, Sattar A, Ashraf H, Rafaqat S. The Role of Coagulation in Heart Failure: A Literature Review. Curr Heart Fail Rep 2024; 21:277-291. [PMID: 38869806 DOI: 10.1007/s11897-024-00671-z] [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] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
PURPOSE OF REVIEW This article summarizes the role of coagulation factors in the pathophysiology of heart failure including D-dimer, fibrinogen and fibrin, prothrombin, p-selectin, tissue factor, tissue plasminogen activator, von Willebrand factor, β-thromboglobulin, Factor XI, tissue thromboplastin, plasminogen activator inhibitor-1 (PAI-1), thrombomodulin, soluble urokinase-type plasminogen activator receptor (suPAR) and stuart-prower factor. RECENT FINDINGS The D-dimer, P-selectin, prothrombin, von Willebrand factor, tissue plasminogen activator, fibrinogen, suPAR, tissue factor, thrombomodulin and Factor XI play significant roles the pathophysiology of heart failure. However, no associations were found between β-thromboglobulin, tissue thromboplastin, PAI-1 and stuart-prower factor in the context of heart failure. Coagulation factors play significant role in the pathophysiology of heart failure. Consequently, the underlying pathophysiological mechanisms that explain changes in the cascade are closely related to the diagnostic, prognostic and therapeutic roles of coagulation cascade factors, which help physicians identify and treat heart failure.
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Affiliation(s)
- Farhan Anjum
- Institute of Zoology, University of Punjab, Quaid-I-Azam Campus, Lahore, Pakistan
| | - Mahrukh Gilani
- Department of the Zoology, Lahore College for Women University, Lahore, Pakistan
| | - Maryam Latif
- Institute of Zoology, University of Punjab, Quaid-I-Azam Campus, Lahore, Pakistan
| | - Aqsa Sattar
- Department of Zoology (Molecular Physiology), Lahore College for Women University, Lahore, Pakistan
| | - Habiba Ashraf
- Department of the Zoology, Lahore College for Women University, Lahore, Pakistan
| | - Saira Rafaqat
- Department of Zoology (Molecular Physiology), Lahore College for Women University, Lahore, Pakistan.
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Zhu D, Wang C, Zhou Y, Che H, Wang R, Cheng L, Rao C, Zhong Q, Li Z, Duan Y, He K. The Associations of Two Novel Inflammation Biomarkers, SIRI and SII, with Mortality Risk in Patients with Chronic Heart Failure. J Inflamm Res 2024; 17:1255-1264. [PMID: 38415264 PMCID: PMC10898362 DOI: 10.2147/jir.s451190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/16/2024] [Indexed: 02/29/2024] Open
Abstract
Background The associations of two novel inflammation biomarkers, systemic inflammation response index (SIRI) and systemic immune inflammation index (SII), with mortality risk in patients with chronic heart failure (CHF) are not well-characterized. Methods This retrospective cohort study included patients with CHF in two medical centers of Chinese People's Liberation Army General Hospital, Beijing, China. The outcomes of this study included in-hospital mortality and long-term mortality. Associations of SIRI and SII with mortality were assessed using multivariable regressions and receiver operating characteristic (ROC) analyses. Results A total of 6232 patients with CHF were included in the present study. We documented 97 cases of in-hospital mortality and 1738 cases of long-term mortality during an average 5.01-year follow-up. Compared with patients in the lowest quartile of SIRI, those in the highest quartile exhibited 134% higher risk of in-hospital mortality (adjusted odds ratio, 2.34; 95% confidence interval [CI], 1.16-4.72) and 45% higher risk of long-term mortality (adjusted hazard ratio, 1.45; 95% CI, 1.25-1.67). Compared with patients in the lowest quartile of SII, those in the highest quartile exhibited 27% higher risk of long-term mortality (adjusted hazard ratio, 1.27; 95% CI, 1.11-1.46). In ROC analyses, SIRI showed better prognostic discrimination than C-reactive protein (area under the curve: 69.39 vs 60.91, P = 0.01, for in-hospital mortality; 61.82 vs 58.67, P = 0.03, for 3-year mortality), whereas SII showed similar prognostic value with C-reactive protein. Conclusion SIRI and SII were significantly associated with mortality risk in patients with CHF. SIRI may provide better prognostic discrimination than C-reactive protein.
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Affiliation(s)
- Di Zhu
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
- Graduate School of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Chi Wang
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - You Zhou
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China
| | - Hebin Che
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Ruiqing Wang
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
- Graduate School of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Liting Cheng
- School of Medicine, Nankai University, Tianjin, 300071, People's Republic of China
| | - Chongyou Rao
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
- Graduate School of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Qin Zhong
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Zongren Li
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Yongjie Duan
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
- Graduate School of PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Kunlun He
- Medical Big Data Research Center, Medical Innovation Research Department of PLA General Hospital, Beijing, 100853, People's Republic of China
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Aynalem M, Adane T, Getawa S. Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital. Vasc Health Risk Manag 2022; 18:617-627. [PMID: 35959111 PMCID: PMC9362846 DOI: 10.2147/vhrm.s371912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 08/01/2022] [Indexed: 11/23/2022] Open
Abstract
Background Heart disease is a leading cause of hospitalization, death, and poor physical function due to comorbid conditions such as atrial fibrillation and stroke. It affects the blood hemostatic system, vasculature, and flow dynamics, causing both arterial and venous thrombosis. Thus, this study aimed to determine the magnitude of coagulation abnormalities among patients with heart disease attending the University of Gondar Comprehensive Specialized hospital. Methods A cross-sectional study was conducted on a total of 98 patients with heart disease. Pretested structured questionnaires were used to collect data on socio-demographic and clinical variables. About 6 mL of venous blood was collected with the vacutainer method and analyzed using Huma cue-due plus and Sysmex KX-21N hematology analyzers for assessing coagulation abnormalities. Stool samples were processed via a direct wet mount. Thin and thick blood films were examined to assess malaria parasites. Data was entered into EPI-Info version 3.5.3 and then transported to SPSS version 20 for analysis. Descriptive statistics were summarized using frequency and percentage. Univariate and multivariate logistic regression models were fitted to identify factors associated with coagulopathy. P-value <0.05 was considered to be statistically significant. Results The overall magnitude of coagulation abnormalities (thrombocytopenia, prolonged prothrombin time, and activated partial thromboplastin time) in patients with heart diseases was 85.7% (95% CI: 81.96, 89.45). Besides, prolonged prothrombin time, prolonged activated partial thromboplastin time, and thrombocytopenia were detected in 83.7%, 33.7%, and 12.2% of the study participants, respectively. Participants who are taking medications for chronic disease (AOR = 0.17; 95% CI: 0.04, 0.69), participants with stroke (AOR = 20; 95% CI: 14.7, 35), and participants taking antibiotics (AOR = 8.17; 95% CI: 1.66, 40.27) were significantly associated with prolonged coagulation time. Conclusion This study showed that patients with heart disease had prolonged prothrombin time, activated partial thromboplastin time, and thrombocytopenia. Therefore, coagulation parameters are required to be checked regularly to monitor coagulation disorders and their complications in heart disease patients.
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Affiliation(s)
- Melak Aynalem
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tiruneh Adane
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Solomon Getawa
- Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Solomon Getawa, Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, P.O. Box: 196, Gondar, Ethiopia, Tel +251-914-665-736, Email
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Chronic Immune Platelet Activation Is Followed by Platelet Refractoriness and Impaired Contractility. Int J Mol Sci 2022; 23:ijms23137336. [PMID: 35806341 PMCID: PMC9266422 DOI: 10.3390/ijms23137336] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/25/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Autoimmune diseases, including systemic lupus erythematosus (SLE), have a high risk of thrombotic and hemorrhagic complications associated with altered platelet functionality. We studied platelets from the blood of SLE patients and their reactivity. The surface expression of phosphatidylserine, P-selectin, and active integrin αIIbβ3 were measured using flow cytometry before and after platelet stimulation. Soluble P-selectin was measured in plasma. The kinetics of platelet-driven clot contraction was studied, as well as scanning and transmission electron microscopy of unstimulated platelets. Elevated levels of membrane-associated phosphatidylserine and platelet-attached and soluble P-selectin correlated directly with the titers of IgG, anti-dsDNA-antibodies, and circulating immune complexes. Morphologically, platelets in SLE lost their resting discoid shape, formed membrane protrusions and aggregates, and had a rough plasma membrane. The signs of platelet activation were associated paradoxically with reduced reactivity to a physiological stimulus and impaired contractility that revealed platelet exhaustion and refractoriness. Platelet activation has multiple pro-coagulant effects, and the inability to fully contract (retract) blood clots can be either a hemorrhagic or pro-thrombotic mechanism related to altered clot permeability, sensitivity of clots to fibrinolysis, obstructiveness, and embologenicity. Therefore, chronic immune platelet activation followed by secondary platelet dysfunction comprise an understudied pathogenic mechanism that supports hemostatic disorders in autoimmune diseases, such as SLE.
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Dahlen B, Schulz A, Göbel S, Tröbs SO, Schwuchow-Thonke S, Spronk HM, Prochaska JH, Arnold N, Lackner KJ, Gori T, Ten Cate H, Münzel T, Wild PS, Panova-Noeva M. The impact of platelet indices on clinical outcome in heart failure: results from the MyoVasc study. ESC Heart Fail 2021; 8:2991-3001. [PMID: 33939298 PMCID: PMC8318485 DOI: 10.1002/ehf2.13390] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/15/2021] [Accepted: 04/13/2021] [Indexed: 12/15/2022] Open
Abstract
Aims Platelet indices have been associated with traditional cardiovascular risk factors, cardiovascular diseases and all‐cause mortality. This study aimed to investigate the role of platelet count, mean platelet volume (MPV) and platelet‐to‐leukocyte ratio, including platelet‐to‐monocyte and platelet‐to‐lymphocyte ratio with cardiac function, heart failure (HF) phenotypes and clinical outcome, worsening of HF. Methods and results Univariate and multivariable linear and Cox regression analyses were used to investigate the associations between platelet indices, cardiac function and worsening of HF in 3250 subjects enrolled in the MyoVasc study. Higher MPV, lower platelet count, lower platelet‐to‐leukocyte and platelet‐to‐monocyte ratios have been associated with reduced left ventricular ejection fraction (beta estimate [β]MPV [fL] = −0.05 [−0.09; −0.02], βplatelet count (× 10/L)9 = 3.4 [1.2; 5.6], βplatelet‐to‐leukocyte ratio = 1.4 [1.1; 1.8], βplatelet‐to‐monocyte ratio = 28 [20; 36]) and increased E/E' ratio (β MPV [fL] = 0.04 [0.003; 0.07], βplatelet count (× 10/L)9 = −3.1 [−5.3; −0.92], βplatelet‐to‐leukocyte ratio = −0.83 [−1.2; −0.46], βplatelet‐to‐monocyte ratio = −20 [−28; −12]), independent of age and sex. Cox regression demonstrated an increased risk for worsening of HF in subjects with MPV > 75th percentile (hazard ratio [HR] = 1.47 [1.16; 1.87]), platelet count < 25th percentile (HR = 1.36 [1.07; 1.74]), platelet‐to‐leukocyte < 25th percentile (HR = 1.53 [1.20; 1.95]), platelet‐to‐monocyte < 25th percentile (HR = 1.38 [1.08; 1.77]) and platelet‐to‐lymphocyte > 75th percentile (HR = 1.50 [1.17; 1.93]) ratios, independent of potential confounders. MPV > 75th percentile and platelet count < 25th percentile were strongly related to outcome in HFpEF vs. HFrEF (P for difference = 0.040). Platelet‐to‐leukocyte ratios were associated with worse outcome in both HF phenotypes, without a significant difference between HFpEF and HFrEF. Conclusions Platelet indices are linked with worse cardiac function and adverse clinical outcome, independent of subjects' underlying cardiovascular profile. This study emphasizes their important value to provide additional information on pathophysiology and risk stratification in HF syndrome.
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Affiliation(s)
- Bianca Dahlen
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Andreas Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sebastian Göbel
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sven-Oliver Tröbs
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sören Schwuchow-Thonke
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Henri M Spronk
- Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jürgen H Prochaska
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany
| | - Natalie Arnold
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J Lackner
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany.,Institute for Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Tommaso Gori
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany.,Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Hugo Ten Cate
- Laboratory for Clinical Thrombosis and Hemostasis, Department of Internal Medicine, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Center, Maastricht, The Netherlands
| | - Thomas Münzel
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany.,Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany
| | - Marina Panova-Noeva
- Clinical Epidemiology and Systems Medicine, Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Rhine Main, Mainz, Germany
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Kanagala P, Arnold JR, Khan JN, Singh A, Gulsin GS, Squire IB, McCann GP, Ng LL. Plasma P-selectin is a predictor of mortality in heart failure with preserved ejection fraction. ESC Heart Fail 2021; 8:2328-2333. [PMID: 33694306 PMCID: PMC8120355 DOI: 10.1002/ehf2.13280] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/28/2021] [Accepted: 02/11/2021] [Indexed: 12/30/2022] Open
Abstract
Aims The aim of the study was to assess the association of P‐selectin with outcomes in heart failure with preserved ejection fraction (HFpEF). Methods and results This is a prospective, observational study of 130 HFpEF patients who underwent clinical profiling, blood sampling, 6 min walk testing, Minnesota Living with Heart Failure Questionnaire evaluation, echocardiography, cardiovascular magnetic resonance imaging, calculation of the Meta‐Analysis Global Group in Chronic Heart Failure (MAGGIC) risk scores, and blinded plasma P‐selectin measurement. Patients were followed up for the endpoint of all‐cause mortality. The HFpEF subgroup with higher P‐selectin levels [overall median 26 372, inter‐quartile range (19 360–34 889) pg/mL] was associated with lower age, higher heart rate, less prevalent atrial fibrillation, more frequent current smoking status, and lower right ventricular end‐diastolic volumes. During follow‐up (median 1428 days), there were 38 deaths. Following maximal sensitivity and specificity receiver operating characteristic curve analysis, P‐selectin levels above 35 506 pg/mL were associated with greater risk of all‐cause mortality [hazard ratio (HR) 2.700; 95% confidence interval (CI) 1.416–5.146; log‐rank P = 0.002]. Following multivariable Cox proportional hazards regression analysis and when added to MAGGIC scores, only P‐selectin (adjusted HR 1.707; 95% CI 1.099–2.650; P < 0.017) and myocardial infarction detected by cardiovascular magnetic resonance imaging (HR 2.377; 95% CI 1.114–5.075; P < 0.025) remained significant predictors. In a final model comprising all three parameters, only P‐selectin (HR 1.447; 95% CI 1.130–1.853; P < 0.003) and MAGGIC scores (HR 1.555; 95% CI 1.136–2.129; P < 0.006) remained independent predictors of death. Adding P‐selectin (0.618, P = 0.035) improved the area under the receiver operating characteristic curve for mortality prediction for MAGGIC scores (0.647, P = 0.009) to 0.710, P < 0.0001. Conclusions Plasma P‐selectin is an independent predictor of mortality and provides incremental prognostic information beyond MAGGIC scores in HFpEF.
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Affiliation(s)
- Prathap Kanagala
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.,Aintree University Hospital, Liverpool, UK.,University of Liverpool, Liverpool, UK
| | - Jayanth R Arnold
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Jamal N Khan
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Gaurav S Gulsin
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Iain B Squire
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
| | - Leong L Ng
- Department of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK
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Mongirdienė A, Laukaitienė J, Skipskis V, Kuršvietienė L, Liobikas J. Platelet Activity and Its Correlation with Inflammation and Cell Count Readings in Chronic Heart Failure Patients with Reduced Ejection Fraction. ACTA ACUST UNITED AC 2021; 57:medicina57020176. [PMID: 33670636 PMCID: PMC7923047 DOI: 10.3390/medicina57020176] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/05/2021] [Accepted: 02/11/2021] [Indexed: 12/01/2022]
Abstract
Background and objectives: There has been an increasing interest in the role of inflammation in thrombosis complications in chronic heart failure (HF) patients. The incidence of thrombosis in HF has been shown to be the highest in patients classified as NYHA IV (New York Heart association). It is stated that inflammation is regulated by platelet-induced activation of blood leukocytes. We aimed to compare the platelet and cell count readings in chronic HF with reduced ejection fraction (HFrEF) patients according to NYHA functional class and to evaluate the correlation between those readings. Materials and methods: A total of 185 patients were examined. The results of heart echoscopy (TEE) testing; fibrinogen, N-terminal pro b-type natriuretic peptide (NT-proBNP), C reactive protein (CRP), and cortisol concentrations; complete blood counts; and a 6 min walking test were assessed and platelet aggregation was determined. Results: Mean platelet volume (MPV) increased with deterioration of a patient’s state (p < 0.005). Lymphocyte count and percentage were the lowest in the NYHA IV group (p < 0.005). Neutrophil and monocyte percentage and count were the highest (p < 0.045) in the NYHA IV group. Adenosine diphosphate (ADP)- and ADR-induced platelet aggregation was higher in the NYHA III group compared to NYHA II and I groups (p < 0.023). NYHA functional class correlated with mean platelet volume (MPV) (r = 0.311, p = 0.0001), lymphocyte count (r = −0.186, p = 0.026), monocyte count (p = 0.172, p = 0.041), and percentage (r = 0.212, p = 0.011). CRP concentration correlated with NT-proBNP (r = 0.203, p = 0.005). MPV correlated with fibrinogen concentration (r = 0.244, p = 0.004). Conclusions: (1) MPV could be considered as an additional reading reflecting a patient’s condition, however the use of MPV to identify patients at risk of hypercoagulable state should be evaluated in more extensive studies; (2) increased neutrophil and monocyte counts could indicate a higher inflammatory state in chronic HFrEF.
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Affiliation(s)
- Aušra Mongirdienė
- Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania; (J.L.); (L.K.); (J.L.)
- Correspondence: or
| | - Jolanta Laukaitienė
- Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania; (J.L.); (L.K.); (J.L.)
- Cardiology Clinic, University Hospital, Lithuanian University of Health Sciences, Eiveniu Str. 2, LT-50161 Kaunas, Lithuania
| | - Vilius Skipskis
- Laboratory of Molecular Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania;
| | - Lolita Kuršvietienė
- Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania; (J.L.); (L.K.); (J.L.)
| | - Julius Liobikas
- Department of Biochemistry, Medicine Academy, Lithuanian University of Health Sciences, Eiveniu Str. 4, LT-50103 Kaunas, Lithuania; (J.L.); (L.K.); (J.L.)
- Laboratory of Biochemistry, Neuroscience Institute, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
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Marcano AL, Lugo LM, Besteiro A, Gomez-Lara J, Roura G, Fuentes L, Gracida M, Teruel L, Romaguera R, Sosa SG, Cequier Á, Gómez-Hospital JA, Comin-Colet J, Ferreiro JL. Association of fractalkine with functional severity of heart failure and impact on clopidogrel efficacy in patients with ischemic heart disease. Thromb Res 2020; 196:215-221. [PMID: 32916563 DOI: 10.1016/j.thromres.2020.08.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patients with heart failure (HF) display elevated levels of soluble fractalkine, a chemokine involved in inflammation processes, atherosclerosis and platelet activation. Further, fractalkine has been associated with reduced pharmacodynamic (PD) responsiveness to clopidogrel. The aim of this study was to investigate the association of fractalkine with the severity of HF and its impact on platelet activation and clopidogrel response in patients with coronary artery disease (CAD) with and without HF. MATERIALS AND METHODS This prospective PD study included 116 stable CAD patients on DAPT with aspirin and clopidogrel. Subjects were classified in two groups: patients with HF and reduced (<40%) left ventricular ejection fraction (HFrEF group, n = 56) and patients without HF (no HF group, n = 60). Clinical severity of HF was graded according to NYHA classification. Platelet function assays included vasodilator-stimulated phosphoprotein assay, multiple electrode aggregometry and light transmittance aggregometry. Fractalkine and P-selectin concentrations were determined by ELISA. RESULTS Fractalkine levels progressively increased with the severity of the disease in the HFrEF group (NYHA I: 471.2 ± 52.4 pg/ml, NYHA II: 500.5 ± 38.4 pg/ml, NYHA III: 638.9 ± 54.3 pg/ml, p for linear trend 0.023). Numerically higher concentrations of fractalkine were observed in the HFrEF group compared to the no HF group with borderline significance (p = 0.052). No significant differences in clopidogrel-induced platelet inhibition according to fractalkine values were observed in any of the groups. CONCLUSIONS Fractalkine levels were increased in patients with HFrEF and positively associated with the functional severity of the disease. No evident impact of fractalkine on clopidogrel PD efficacy was found.
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Affiliation(s)
- Ana Lucrecia Marcano
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Leslie Marisol Lugo
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Dobney Hypertension Centre, School of Medicine - Royal Perth Hospital Unit/Medical Research Foundation, University of Western Australia, Perth, Australia
| | - Adrián Besteiro
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Gomez-Lara
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Gerard Roura
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lara Fuentes
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Montserrat Gracida
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Luis Teruel
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Romaguera
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Silvia Gabriela Sosa
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Ángel Cequier
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, CIBER-CV, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Joan A Gómez-Hospital
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, CIBER-CV, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Comin-Colet
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - José Luis Ferreiro
- Department of Cardiology, Hospital Universitario de Bellvitge - IDIBELL, CIBER-CV, L'Hospitalet de Llobregat, Barcelona, Spain.
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Bouwens E, van den Berg VJ, Akkerhuis KM, Baart SJ, Caliskan K, Brugts JJ, Mouthaan H, van Ramshorst J, Germans T, Umans VAWM, Boersma E, Kardys I. Circulating Biomarkers of Cell Adhesion Predict Clinical Outcome in Patients with Chronic Heart Failure. J Clin Med 2020; 9:E195. [PMID: 31936828 PMCID: PMC7020068 DOI: 10.3390/jcm9010195] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 12/31/2022] Open
Abstract
Cardiovascular inflammation and vascular endothelial dysfunction are involved in chronic heart failure (CHF), and cellular adhesion molecules are considered to play a key role in these mechanisms. We evaluated temporal patterns of 12 blood biomarkers of cell adhesion in patients with CHF. In 263 ambulant patients, serial, tri-monthly blood samples were collected during a median follow-up of 2.2 (1.4-2.5) years. The primary endpoint (PE) was a composite of cardiovascular mortality, HF hospitalization, heart transplantation and implantation of a left ventricular assist device and was reached in 70 patients. We selected the baseline blood samples in all patients, the two samples closest to a PE, or, for event-free patients, the last sample available. In these 567 samples, associations between biomarkers and PE were investigated by joint modelling. The median age was 68 (59-76) years, with 72% men and 74% New York Heart Association class I-II. Repeatedly measured levels of Complement component C1q receptor (C1qR), Cadherin 5 (CDH5), Chitinase-3-like protein 1 (CHI3L1), Ephrin type-B receptor 4 (EPHB4), Intercellular adhesion molecule-2 (ICAM-2) and Junctional adhesion molecule A (JAM-A) were independently associated with the PE. Their rates of change also predicted clinical outcome. Level of CHI3L1 was numerically the strongest predictor with a hazard ratio (HR) (95% confidence interval) of 2.27 (1.66-3.16) per SD difference in level, followed by JAM-A (2.10, 1.42-3.23) and C1qR (1.90, 1.36-2.72), adjusted for clinical characteristics. In conclusion, temporal patterns of C1qR, CDH5, CHI3L1, EPHB4, ICAM2 and JAM-A are strongly and independently associated with clinical outcome in CHF patients.
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Intravascular cells and circulating microparticles induce procoagulant activity via phosphatidylserine exposure in heart failure. J Thromb Thrombolysis 2020; 48:187-194. [PMID: 31177487 DOI: 10.1007/s11239-019-01889-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Relatively little information is known about the definitive role of phosphatidylserine (PS) in the hypercoagulability of heart failure (HF). Our objectives were to assess the levels of PS exposure on microparticles (MPs) and blood cells (BCs) in each group of HF patients and to evaluate their procoagulant activity (PCA). HF patients in each NYHA functional class II-IV (II n = 30, III n = 30, IV n = 30) and healthy controls (n = 25) were enrolled in the present study. PS exposure on MPs, BCs was analyzed with flow cytometry. MPs were classified based on their cellular origin: platelets (CD41a+), neutrophils (CD66b+), endothelial cells (CD31+CD41a-), erythrocytes (CD235a+), monocytes (CD14+), T lymphocytes (CD3+), and B lymphocytes (CD19+). PCA was evaluated by clotting time, extrinsic/intrinsic FXa and prothrombinase production assays, as well as fibrin formation assays. Inhibition assays of PCA of PS+ BCs and MPs were performed by lactadherin. There was no significant difference in MP cellular origin between healthy and HF subjects. However, the total number of PS+ MPs was significantly increased in HF patients compared with healthy controls. In addition, circulating PS+ BCs cooperated with PS+ MPs to markedly shorten coagulation time and dramatically increase FXa/thrombin generation and fibrin formation in each HF group. Moreover, blockade of exposed PS on BCs and MPs with lactadherin inhibited PCA by approximately 80%. Our results lead us to believe that exposing PS on the injured BCs and MPs played a pivotal role in the hypercoagulability state in HF patients.
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11
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Circulating P-Selectin and Its Glycoprotein Ligand in Nondiabetic Obstructive Sleep Apnea Patients. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1279:61-69. [PMID: 32170667 DOI: 10.1007/5584_2020_501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Selectins and their ligands play an important role in atherosclerosis. The role of these adhesion molecules in the pathogenesis of obstructive sleep apnea (OSA) may be of clinical relevance. Therefore, the aim of this study was to assess the serum content of platelet P-selectin (P-SEL) and P-selectin glycoprotein ligand 1 (PSGL-1) in different OSA stages. The study was performed in nondiabetic patients, aged 32-71, in whom OSA was verified by polysomnography. The apnea/hypopnea index (AHI) was used to stratify OSA stages: AHI <5, no sleep pathology (OSA-0); AHI 5-15, (OSA-1); AHI 16-30, (OSA-2); and AHI >30, (OSA-3). There were 16 patients in each group. P-SEL and PSGL-1 were assessed by ELISA kits. There were no appreciable differences in the patients' glucose or high-specificity C-reactive protein content. We found that P-SEL and PSGL-1 significantly increased from OSA-0 to OSA-3. There were the following positive associations in all OSA patients: P-SEL vs. AHI, PSGL-1 vs. AHI, and P-SEL vs. PSGL-1. In addition, the adhesion molecules are associated with the anthropometric parameters, oxygen saturation, and sleep architecture in the OSA-1 group. We conclude that the adhesion molecules consistently increase in the blood of nondiabetic OSA patients, along with progression of disorder severity.
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Braune S, Latour RA, Reinthaler M, Landmesser U, Lendlein A, Jung F. In Vitro Thrombogenicity Testing of Biomaterials. Adv Healthc Mater 2019; 8:e1900527. [PMID: 31612646 DOI: 10.1002/adhm.201900527] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 08/15/2019] [Indexed: 12/29/2022]
Abstract
The short- and long-term thrombogenicity of implant materials is still unpredictable, which is a significant challenge for the treatment of cardiovascular diseases. A knowledge-based approach for implementing biofunctions in materials requires a detailed understanding of the medical device in the biological system. In particular, the interplay between material and blood components/cells as well as standardized and commonly acknowledged in vitro test methods allowing a reproducible categorization of the material thrombogenicity requires further attention. Here, the status of in vitro thrombogenicity testing methods for biomaterials is reviewed, particularly taking in view the preparation of test materials and references, the selection and characterization of donors and blood samples, the prerequisites for reproducible approaches and applied test systems. Recent joint approaches in finding common standards for a reproducible testing are summarized and perspectives for a more disease oriented in vitro thrombogenicity testing are discussed.
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Affiliation(s)
- Steffen Braune
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
| | - Robert A. Latour
- Rhodes Engineering Research CenterDepartment of BioengineeringClemson University Clemson SC 29634 USA
| | - Markus Reinthaler
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Department for CardiologyCharité UniversitätsmedizinCampus Benjamin Franklin Hindenburgdamm 30 12203 Berlin Germany
| | - Ulf Landmesser
- Department for CardiologyCharité UniversitätsmedizinCampus Benjamin Franklin Hindenburgdamm 30 12203 Berlin Germany
| | - Andreas Lendlein
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Institute of ChemistryUniversity of Potsdam Karl‐Liebknecht‐Strasse 24‐25 14476 Potsdam Germany
- Helmholtz Virtual Institute “Multifunctional Biomaterials for Medicine”Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
| | - Friedrich Jung
- Institute of Biomaterial Science and Berlin‐Brandenburg Centre for Regenerative Therapies (BCRT)Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
- Helmholtz Virtual Institute “Multifunctional Biomaterials for Medicine”Helmholtz‐Zentrum Geesthacht Kantstrasse 55 14513 Teltow Germany
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Is the endothelial cell responsible for the thrombus core and shell architecture? Med Hypotheses 2019; 129:109244. [PMID: 31371073 DOI: 10.1016/j.mehy.2019.109244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/12/2019] [Accepted: 05/22/2019] [Indexed: 11/24/2022]
Abstract
Ischemia leading to heart attacks and strokes is the major cause of deaths in the world. This report explores the possibility that intracellular material from ruptured endothelial cells is partially responsible for the heterogeneous core-and-shell blood clot architecture, typically observed using intravital microscopy. As evidence, we present a fluid dynamic argument that platelet agonists emanating from the injury cannot activate platelets in the thrombus core, given that they would have to travel against flow of blood escaping into the extravascular. Furthermore, we demonstrate visual evidence that the core material appears to be continuous and originating from the damaged endothelium. Finally, we present a mechanism, illustrating the steps of platelet recruitment into the thrombus and sealing of the injury. If correct, the model presented herein will be beneficial to the understanding and treatment of heart attacks, strokes and hemophilia.
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Comparative symptom biochemistry between moderate and advanced heart failure. Heart Lung 2018; 47:565-575. [PMID: 30314637 DOI: 10.1016/j.hrtlng.2018.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 01/11/2023]
Abstract
BACKGROUND We have a limited understanding of the biological underpinnings of symptoms in heart failure (HF). OBJECTIVES The purpose of this paper was to compare relationships between peripheral biomarkers of HF pathogenesis and physical symptoms between patients with advanced versus moderate HF. METHODS This was a two-stage phenotype sampling cohort study wherein we examined patients with advanced HF undergoing ventricular assist device implantation in the first stage, and then patients with moderate HF (matched adults with HF not requiring device implantation) in the second stage. Linear modeling was used to compare relationships among biomarkers and physical symptoms between cohorts. RESULTS Worse myocardial stress, systemic inflammation and endothelial dysfunction were associated with worse physical symptoms in moderate HF (n=48), but less physical symptom burden in advanced HF (n=48). CONCLUSIONS Where patients are in the HF trajectory needs to be taken into consideration when exploring biological underpinnings of physical HF symptoms.
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15
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Berger R, Hammer A, Hutuleac R, Koppensteiner R, Kopp C, Steiner S, Moertl D. Dose-dependent decrease of platelet activation and tissue factor by omega-3 polyunsaturated fatty acids in patients with advanced chronic heart failure. Thromb Haemost 2017; 106:457-65. [DOI: 10.1160/th11-03-0169] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 05/26/2011] [Indexed: 11/05/2022]
Abstract
SummaryChronic heart failure (CHF) is characterised by activation of neuroendocrine and inflammatory pathways, and both are linked to a prothrombotic state. Treatment with omega-3 polyunsaturated fatty acids (n3-PUFA) showed significant benefits including mortality reduction in CHF, but exact mechanisms of action are still unclear. We investigated the effects of n3-PUFA on markers of platelet activation and thrombogenesis in patients with severe CHF. Thirty-six patients with non-ischaemic CHF (LVEF<35%, NYHA class>2) under optimised therapy were randomised to supplementation with 1g/day or 4g/day n3-PUFA, or placebo for 12 weeks. Using whole-blood flow cytometry, monocyteplatelet aggregates characterised by CD14+/CD42b+ co-expression and monocytic tissue factor (TF) were determined. Plasma levels of P-selectin, sCD40L, fibrinogen, prothrombin fragment F1.2, TF and proinflammatory markers (high sensitive[hs] interleukin-6, hsCRP, hsTNFalpha, monocyte chemotactic protein-1) were measured by immunoassay. Supplementation with 1g/day and 4g/day n3-PUFA but not placebo significantly reduced monocyte-platelet aggregates in a dose-dependent manner (p for trend=0.02 across the groups). A dose of 4g/day but not 1g/day n3-PUFA significantly decreased P-selectin (p=0.03). Plasma TF decreased dose-dependently upon n3-PUFA supplementation (p for trend=0.02), paralleled by a significant decrease of TF+-monocytes (p for trend=0.01). The amount of 4g/day n3-PUFA exhibited modest anti-inflammatory effects with a significant reduction of hs interleukin-6 (p<0.01) and a trend-wise reduction of hsTNF-alpha (p=0.09). No changes were seen for sCD40L, fibrinogen, hsCRP and monocyte chemotactic protein-1, while F1.2 was decreased by 4g/day n3-PUFA (P=0.03). In patients with severe non-ischaemic CHF, treatment with n3-PUFA leads to a dose-dependent decrease of platelet activation and TF. Higher dosage exhibits also anti-inflammatory effects.* ClinicalTrials.gov registration number: NCT00149409
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Raphael R, Purushotham D, Gastonguay C, Chesnik MA, Kwok WM, Wu HE, Shah SJ, Mirza SP, Strande JL. Combining patient proteomics and in vitro cardiomyocyte phenotype testing to identify potential mediators of heart failure with preserved ejection fraction. J Transl Med 2016; 14:18. [PMID: 26792056 PMCID: PMC4719542 DOI: 10.1186/s12967-016-0774-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 01/06/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Heart failure with ejection fraction (HFpEF) is a syndrome resulting from several co-morbidities in which specific mediators are unknown. The platelet proteome responds to disease processes. We hypothesize that the platelet proteome will change composition in patients with HFpEF and may uncover mediators of the syndrome. METHODS AND RESULTS Proteomic changes were assessed in platelets from hospitalized subjects with symptoms of HFpEF (n = 9), the same subjects several weeks later without symptoms (n = 7) and control subjects (n = 8). Mass spectrometry identified 6102 proteins with five scans with peptide probabilities of ≥0.85. Of the 6102 proteins, 165 were present only in symptomatic subjects, 78 were only found in outpatient subjects and 157 proteins were unique to the control group. The S100A8 protein was identified consistently in HFpEF samples when compared with controls. We validated the fining that plasma S100A8 levels are increased in subjects with HFpEF (654 ± 391) compared to controls (352 ± 204) in an external cohort (p = 0.002). Recombinant S100A8 had direct effects on the electrophysiological and calcium handling profile in human induced pluripotent stem cell-derived cardiomyocytes. CONCLUSIONS Platelets may harbor proteins associated with HFpEF. S100A8 is present in the platelets of subjects with HFpEF and increased in the plasma of the same subjects. We further established a bedside-to-bench translational system that can be utilized as a secondary screen to ascertain whether the biomarkers may be an associated finding or causal to the disease process. S100A8 has been linked with other cardiovascular disease such as atherosclerosis and risk for myocardial infarction, stroke, or death. This is the first report on association of S100A8 with HFpEF.
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Affiliation(s)
- Roseanne Raphael
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Diana Purushotham
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Courtney Gastonguay
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA. .,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. .,Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Marla A Chesnik
- Biotechnology and Bioengineering, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Wai-Meng Kwok
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Hsiang-En Wu
- Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Sanjiv J Shah
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Shama P Mirza
- Biotechnology and Bioengineering, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - Jennifer L Strande
- Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, USA. .,Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. .,Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. .,, MEB/CVC 4579, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
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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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Burfeind KG, Michaelis KA, Marks DL. The central role of hypothalamic inflammation in the acute illness response and cachexia. Semin Cell Dev Biol 2015; 54:42-52. [PMID: 26541482 DOI: 10.1016/j.semcdb.2015.10.038] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/26/2015] [Indexed: 12/19/2022]
Abstract
When challenged with a variety of inflammatory threats, multiple systems across the body undergo physiological responses to promote defense and survival. The constellation of fever, anorexia, and fatigue is known as the acute illness response, and represents an adaptive behavioral and physiological reaction to stimuli such as infection. On the other end of the spectrum, cachexia is a deadly and clinically challenging syndrome involving anorexia, fatigue, and muscle wasting. Both of these processes are governed by inflammatory mediators including cytokines, chemokines, and immune cells. Though the effects of cachexia can be partially explained by direct effects of disease processes on wasting tissues, a growing body of evidence shows the central nervous system (CNS) also plays an essential mechanistic role in cachexia. In the context of inflammatory stress, the hypothalamus integrates signals from peripheral systems, which it translates into neuroendocrine perturbations, altered neuronal signaling, and global metabolic derangements. Therefore, we will discuss how hypothalamic inflammation is an essential driver of both the acute illness response and cachexia, and why this organ is uniquely equipped to generate and maintain chronic inflammation. First, we will focus on the role of the hypothalamus in acute responses to dietary and infectious stimuli. Next, we will discuss the role of cytokines in driving homeostatic disequilibrium, resulting in muscle wasting, anorexia, and weight loss. Finally, we will address mechanisms and mediators of chronic hypothalamic inflammation, including endothelial cells, chemokines, and peripheral leukocytes.
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Affiliation(s)
- Kevin G Burfeind
- Papé Family Pediatric Research Institute, Oregon Health & Science University, Portland, OR, USA
- MD/PhD Program, Oregon Health & Science University, Portland, OR, USA
| | - Katherine A Michaelis
- Papé Family Pediatric Research Institute, Oregon Health & Science University, Portland, OR, USA
- MD/PhD Program, Oregon Health & Science University, Portland, OR, USA
| | - Daniel L Marks
- Papé Family Pediatric Research Institute, Oregon Health & Science University, Portland, OR, USA
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Glezeva N, Gilmer JF, Watson CJ, Ledwidge M. A Central Role for Monocyte-Platelet Interactions in Heart Failure. J Cardiovasc Pharmacol Ther 2015; 21:245-61. [PMID: 26519384 DOI: 10.1177/1074248415609436] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 08/04/2015] [Indexed: 01/08/2023]
Abstract
Heart failure (HF) is an increasingly prevalent and costly multifactorial syndrome with high morbidity and mortality rates. The exact pathophysiological mechanisms leading to the development of HF are not completely understood. Several emerging paradigms implicate cardiometabolic risk factors, inflammation, endothelial dysfunction, myocardial fibrosis, and myocyte dysfunction as key factors in the gradual progression from a healthy state to HF. Inflammation is now a recognized factor in disease progression in HF and a therapeutic target. Furthermore, the monocyte-platelet interaction has been highlighted as an important pathophysiological link between inflammation, thrombosis, endothelial activation, and myocardial malfunction. The contribution of monocytes and platelets to acute cardiovascular injury and acute HF is well established. However, their role and interaction in the pathogenesis of chronic HF are not well understood. In particular, the cross talk between monocytes and platelets in the peripheral circulation and in the vicinity of the vascular wall in the form of monocyte-platelet complexes (MPCs) may be a crucial element, which influences the pathophysiology and progression of chronic heart disease and HF. In this review, we discuss the role of monocytes and platelets as key mediators of cardiovascular inflammation in HF, the mechanisms of cell activation, and the importance of monocyte-platelet interaction and complexes in HF pathogenesis. Finally, we summarize recent information on pharmacological inhibition of inflammation and studies of antithrombotic strategies in the setting of HF that can inform opportunities for future work. We discuss recent data on monocyte-platelet interactions and the potential benefits of therapy directed at MPCs, particularly in the setting of HF with preserved ejection fraction.
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Affiliation(s)
- Nadezhda Glezeva
- School of Medicine & Medical Science, UCD Conway Institute, University College Dublin, Dublin, Belfield, Dublin, Ireland
| | - John F Gilmer
- School of Pharmacy & Pharmaceutical Sciences, TCD Centre for Health Sciences, Trinity College Dublin, College Green, Dublin, Ireland
| | - Chris J Watson
- School of Medicine & Medical Science, UCD Conway Institute, University College Dublin, Dublin, Belfield, Dublin, Ireland
| | - Mark Ledwidge
- Chronic Cardiovascular Disease Management Unit and Heart Failure Unit, St Vincent's Healthcare Group/St Michael's Hospital, County Dublin, Ireland
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Chen Y, Zhuo X, Lin Y, Huang W, Xiao J, Zeng J, Jiang L, Chen C, Lin H, Dettke M. Association of ABO blood group with P-selectin levels in Chinese Han healthy volunteers. Transfusion 2015; 55:2759-65. [PMID: 26095340 DOI: 10.1111/trf.13212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 05/04/2015] [Accepted: 05/25/2015] [Indexed: 12/26/2022]
Abstract
BACKGROUND Recent genome-wide association studies in Caucasians suggested that an association exists between the ABO gene locus and soluble levels of P-selectin (sP-selectin). However, it is unclear if the relationship corresponds to the phenotypic expression of ABO groups or is present in different ethnic groups. The aim of this study was to verify this observation at both genotypic and phenotypic levels in a healthy Chinese population. STUDY DESIGN AND METHODS The ABO blood groups were determined by both phenotypes and genotypes in 440 healthy Chinese Han volunteers, while P-selectin levels were evaluated for sP-selectin and total platelet P-selectin (pP-selectin). RESULTS ABO phenotyping and quantitative analysis of individual sP-selectin plasma levels were combined to demonstrate that individuals phenotypically expressing the A antigen have approximately 20% lower sP-selectin plasma levels than those carrying the B or O phenotype (p < 0.0001), but that no difference exists between A and AB and between B and O phenotypes. Genotyping data revealed that the presence of the A gene could be attributed to the observed difference in phenotype comparison, with no difference between A/A, A/B, and A/O genotypes. There were also no associations between ABO blood groups, either phenotypes or genotypes, and pP-selectin levels. CONCLUSION This study demonstrated an association between sP-selectin levels and ABO groups in a Chinese Han population, implicating its generalizability to other ethnic groups. This finding will improve the understanding of the mechanism of ABO blood group-associated diseases.
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Affiliation(s)
- Ying Chen
- Fujian Provincial Cancer Hospital, the Affiliated Hospital of Fujian Medical University.,Fujian Provincial Blood Center, Fuzhou, China
| | - Xiaofu Zhuo
- Fujian Provincial Blood Center, Fuzhou, China
| | | | | | - Jingrong Xiao
- Fujian Provincial Cancer Hospital, the Affiliated Hospital of Fujian Medical University
| | - Jia Zeng
- Fujian Provincial Blood Center, Fuzhou, China
| | - Li Jiang
- Fujian Provincial Blood Center, Fuzhou, China
| | - Cen Chen
- Fujian Provincial Blood Center, Fuzhou, China
| | - Haijuan Lin
- Fujian Provincial Blood Center, Fuzhou, China
| | - Markus Dettke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria
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Budak YU, Huysal K, Demirci H. Correlation between mean platelet volume and B-type natriuretic peptide concentration in emergency patients with heart failure. Biochem Med (Zagreb) 2015; 25:97-102. [PMID: 25672473 PMCID: PMC4401304 DOI: 10.11613/bm.2015.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Accepted: 11/29/2014] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND In heart failure patients, mean platelet volume (MPV) may reflect increased platelet activation or increased numbers of large, hyper-aggregable platelets. B-type natriuretic peptide (BNP) concentration in blood is a sensitive and specific marker of heart failure, correlating with the severity and prognosis of illness, in patients presenting with acute dyspnea to the emergency department. This study evaluated the correlation between BNP concentration and MPV. MATERIAL AND METHODS Data were collected from 319 patients admitted to the emergency department of a cardiology hospital from January-July 2014. EDTA blood samples drawn at admission were analyzed using automated hematology system, and BNP concentration was measured using a fluorescence immunoassay. RESULTS The study included 190 patients with and 129 without acute heart failure (AHF). These groups had BNP concentration of 200-5000 ng/L and 5-98 ng/L, respectively. MPV levels were significantly higher in the AHF group (P<0.001). BNP concentrations were positively correlated with MPV (r=0.41, P<0.001) and neutrophil/lymphocyte ratio (r=0.38, P<0.001). CONCLUSION Increased MPV values correlate with BNP concentration, an indicator of HF severity and clinical status, in patients with AHF admitted to the emergency department.
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Affiliation(s)
- Yasemin U Budak
- Department of Clinical Laboratory, Yuksek Ihtisas Education and Research Hospital, Bursa, Turkey
| | - Kağan Huysal
- Department of Clinical Laboratory, Sevket Yilmaz Education and Research Hospital Bursa, Turkey
| | - Hakan Demirci
- Department of Family Medicine, Sevket Yilmaz Education and Research Hospital, Bursa, Turkey
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Alehagen U, Lindahl TL. sP-selectin is a useful biomarker for cardiovascular risk. Cardiovasc Endocrinol 2015. [DOI: 10.1097/xce.0000000000000042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Jilma-Stohlawetz P, Mannhalter C, Kaider A, Waidacher T, Jilma B, Panzer S. The association of the Thr715Pro P-selectin genotype with levels of P-selectin in platelet concentrates. Vox Sang 2014; 107:368-74. [DOI: 10.1111/vox.12175] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 05/08/2014] [Accepted: 05/16/2014] [Indexed: 11/27/2022]
Affiliation(s)
- P. Jilma-Stohlawetz
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - C. Mannhalter
- Department of Laboratory Medicine; Medical University of Vienna; Vienna Austria
| | - A. Kaider
- Section for Clinical Biometrics; Center for Medical Statistics, Informatics and Intelligent Systems; Medical University of Vienna; Vienna Austria
| | - T. Waidacher
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
| | - B. Jilma
- Department of Clinical Pharmacology; Medical University of Vienna; Vienna Austria
| | - S. Panzer
- Department of Blood Group Serology and Transfusion Medicine; Medical University of Vienna; Vienna Austria
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Prom R, Usedom JE, Dull RB. Antithrombotics in Heart Failure With Reduced Ejection Fraction and Normal Sinus Rhythm. Ann Pharmacother 2013; 48:226-37. [DOI: 10.1177/1060028013511058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To review the thromboembolic risk, pathophysiology associated with the risk, and literature investigating the use of antithrombotics in patients with heart failure with reduced ejection fraction and normal sinus rhythm (HFrEF-NSR). Data Sources: An English language literature search was performed with MEDLINE/PubMed and Embase from January 1950 to October 2013 using the search terms heart failure, HFrEF, systolic heart failure, cardiomyopathy, left ventricular dysfunction, sinus rhythm, thromboembolism, deep vein thrombosis, pulmonary embolism, myocardial infarction, acute coronary syndrome, acute coronary events, coronary artery disease, stroke, and cerebrovascular events to identify relevant articles. References in the retrieved articles were also assessed to identify other important articles. Study Selection and Data Abstraction: All pertinent original studies, reviews, consensus documents, and guidelines were evaluated for inclusion. Data Synthesis: Patients with HFrEF-NSR may be predisposed to developing thromboembolic events. Studies that have examined the role of antithrombotics (warfarin and/or antiplatelet therapy) for reducing thromboembolic risk have been inconclusive. The WASH and HELAS pilot trials—the only studies with a no-antithrombotics or placebo comparator group—did not find a benefit with antithrombotic therapy but found an increased risk of bleeding with warfarin and of hospitalizations with aspirin. Although the clinical outcome studies (WATCH and WARCEF) suggested that warfarin may reduce stroke risk compared with antiplatelet therapy, the lack of a placebo group and lower-than-projected enrollment prevents definitive conclusions from being made. Conclusions: Current evidence does not support the routine use of antithrombotics for preventing thromboembolic events in patients with HFrEF-NSR without compelling indications.
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Mentz RJ, Lazzarini V, Fiuzat M, Metra M, O'Connor CM, Felker GM. Is there a rationale for antiplatelet therapy in acute heart failure? Circ Heart Fail 2013; 6:869-76. [PMID: 23861506 DOI: 10.1161/circheartfailure.112.000381] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Robert J Mentz
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27705, USA
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Colombo PC, Ganda A, Lin J, Onat D, Harxhi A, Iyasere JE, Uriel N, Cotter G. Inflammatory activation: cardiac, renal, and cardio-renal interactions in patients with the cardiorenal syndrome. Heart Fail Rev 2013; 17:177-90. [PMID: 21688186 DOI: 10.1007/s10741-011-9261-3] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although inflammation is a physiologic response designed to protect us from infection, when unchecked and ongoing it may cause substantial harm. Both chronic heart failure (CHF) and chronic kidney disease (CKD) are known to cause elaboration of several pro-inflammatory mediators that can be detected at high concentrations in the tissues and blood stream. The biologic sources driving this chronic inflammatory state in CHF and CKD are not fully established. Traditional sources of inflammation include the heart and the kidneys which produce a wide range of pro-inflammatory cytokines in response to neurohormones and sympathetic activation. However, growing evidence suggests that non-traditional biomechanical mechanisms such as venous and tissue congestion due to volume overload are also important as they stimulate endotoxin absorption from the bowel and peripheral synthesis and release of pro-inflammatory mediators. Both during the chronic phase and, more rapidly, during acute exacerbations of CHF and CKD, inflammation and congestion appear to amplify each other resulting in a downward spiral of worsening cardiac, vascular, and renal functions that may negatively impact patients' outcome. Anti-inflammatory treatment strategies aimed at attenuating end organ damage and improving clinical prognosis in the cardiorenal syndrome have been disappointing to date. A new therapeutic paradigm may be needed, which involves different anti-inflammatory strategies for individual etiologies and stages of CHF and CKD. It may also include specific (short-term) anti-inflammatory treatments that counteract inflammation during the unsettled phases of clinical decompensation. Finally, it will require greater focus on volume overload as an increasingly significant source of systemic inflammation in the cardiorenal syndrome.
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Affiliation(s)
- Paolo C Colombo
- Department of Medicine, Division of Cardiology, Columbia University Medical Center, College of Physicians and Surgeons, New York, NY, USA.
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Nagy V, Kolozsvari B, Balogh Z, Csutak A, Kasza M, Nagy B, Kardos L, Berta A, Pfliegler G. Increased level of platelet P-selectin in nonarteritic anterior ischemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol 2012; 251:917-22. [PMID: 23229830 DOI: 10.1007/s00417-012-2196-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 10/04/2012] [Accepted: 10/30/2012] [Indexed: 10/27/2022] Open
Abstract
PURPOSE P-selectin receptor is expressed in platelets and endothelial cells in a cell-activation-dependent manner. Platelet P-selectin (CD62) levels may become elevated in a number of vasoocclusive diseases, including arteriosclerosis, atherothrombosis, and diabetes mellitus (DM). Nonarteritic anterior ischemic optic neuropathy (NAION) is associated with a sudden loss of vision due to the vascular insufficiency of ciliary arteries supplying the optic nerve. In this study, our aim was to investigate the presence of increased platelet reactivity in the development of NAION. METHODS Twenty-one NAION patients, 39 healthy control subjects, and 44 patients suffering from diabetes mellitus (DM) were examined in our case-control, pilot study. Platelet activation was investigated by flow cytometric analysis of the mean fluorescence intensity (MFI) of CD62 on platelets. These results were compared among the different study groups. RESULTS NAION patients showed considerably although not significantly (p = 0.2017) higher P-selectin MFI values (71.98 ± 40.30) versus healthy subjects (55.48 ± 20.95), insulin-dependent DM patients (50.02 ± 13.08), and non-insulin-dependent DM subjects (54.72 ± 24.74). However, logistic regression analysis resulted in a statistically significant adjusted effect on the odds of NAION when CD62 MFI values were logarithmically transformed (OR: 3.86, 95 % CI: 1.10 to 13.53, p = 0.0346). CONCLUSION Elevated platelet CD62 positivity may be related to NAION, suggesting a possible role of enlarged platelet activity in the generation of this type of ischemic optic neuropathy.
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Affiliation(s)
- Valeria Nagy
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Nagyerdei krt 98, 4012 Debrecen, Hungary.
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Badr Eslam R, Gremmel T, Schneller A, Stegfellner M, Kaider A, Mannhalter C, Lang I, Panzer S. High levels of platelet-monocyte aggregates after valve replacement for aortic stenosis: Relation to soluble P-selectin and P-selectin glycoprotein ligand-1 genes. Thromb Res 2012; 129:453-8. [DOI: 10.1016/j.thromres.2011.07.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Revised: 07/03/2011] [Accepted: 07/12/2011] [Indexed: 02/06/2023]
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Stępień E, Stankiewicz E, Zalewski J, Godlewski J, Zmudka K, Wybrańska I. Number of microparticles generated during acute myocardial infarction and stable angina correlates with platelet activation. Arch Med Res 2012; 43:31-5. [PMID: 22306248 DOI: 10.1016/j.arcmed.2012.01.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 01/11/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Elevated levels of circulating microparticles (MPs) have been reported in patients with acute myocardial infarction (AMI) and coronary artery disease. Platelet activation and inflammation have been recognized during AMI and stable angina (SA). We hypothesize that the origin and count of MPs in AMI and SA patients are related to markers of inflammation and platelet activation. METHODS Platelet, monocytes and endothelial MPs and surface P-selectin were determined in 12 AMI patients, 10 SA patients and 9 controls by flow cytometry. Plasma P-selectin, CD40 ligand (sCD40L) and interleukin 6 (IL-6) levels were evaluated by ELISA methods. RESULTS The total MP count was compared in control subjects, AMI, and SA patients: 12,765 (8465) vs. 38,750 (11,931) vs. 29,715 (12,072) counts/μl (p = 0.01), respectively. Patients with AMI displayed higher levels of total and platelet origin- tissue factor-positive (CD42/CD142) MPs than patients with SA: 72.8 (6.2) vs. 56.2 (6.4) %, p = 0.001. Levels of soluble P-selectin were significantly elevated in patients with AMI as compared to SA patients: 146 (6.5) vs. 107 (2.7) ng/mL, p = 0.005; significant correlation between total MP count and relative number of CD34, CD51, CD42-positive MPs, and the P-selectin expression was observed in patients with AMI. CONCLUSIONS Platelet activation in AMI is associated with increased generation of MPs not only from platelets, but also monocytes and endothelial cells. It suggests that interactions between platelets, monocytes and endothelial cells play an important role in the pathogenesis of myocardial ischemia.
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Affiliation(s)
- Ewa Stępień
- Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland.
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de Meirelles LR, Resende ADC, Matsuura C, Salgado A, Pereira NR, Cascarelli PG, Mendes-Ribeiro AC, Brunini TMC. Platelet activation, oxidative stress and overexpression of inducible nitric oxide synthase in moderate heart failure. Clin Exp Pharmacol Physiol 2012; 38:705-10. [PMID: 21806669 DOI: 10.1111/j.1440-1681.2011.05580.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
1. Chronic heart failure (CHF) is a common disabling disorder associated with thromboembolic events, the genesis of which is not yet fully understood. Nitric oxide (NO), derived from the vascular endothelium and platelets, has an important role in the physiological regulation of blood flow. It is generated from the amino acid L-arginine via NO synthase (NOS). 2. The main objective of the present study was to investigate NO production and its relationship with platelet aggregation, oxidative stress, inflammation and related amino acids in patients with moderate CHF. The expression and activity of NOS isoforms were analysed by western blotting and conversion of L-[(3)H]-arginine to L-[(3)H]-citrulline, respectively, in CHF patients (n = 12) and healthy controls (n = 15). Collagen- and ADP-induced platelet aggregation, oxidative stress (thiobarbituric acid-reactive substances (TBARS) formation and superoxide dismutase (SOD) activity) and plasma levels of amino acids and inflammatory markers (fibrinogen and C-reactive protein (CRP)) were also determined. 3. Both collagen- and ADP-induced platelet aggregation were increased in CHF patients compared with controls. Platelets from CHF patients did not show any changes in NOS activity in the presence of overexpression of inducible NOS. Systemic and intraplatelet TBARS production was elevated, whereas SOD activity was decreased in CHF patients. l-arginine plasma concentrations were lower in CHF patients than in controls. Systemic levels of CRP and fibrinogen were increased in CHF patients. 4. The results show that, in patients with moderate CHF, there is platelet activation and reduced intraplatelet NO bioavailability due to oxidative stress, which suggests a role for platelets in the prothrombotic state.
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Affiliation(s)
- Luisa R de Meirelles
- Departament of Pharmacology and Psychobiology, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Gasparyan AY, Stavropoulos-Kalinoglou A, Mikhailidis DP, Douglas KMJ, Kitas GD. Platelet function in rheumatoid arthritis: arthritic and cardiovascular implications. Rheumatol Int 2011; 17:47-58. [PMID: 20390282 DOI: 10.2174/138161211795049804] [Citation(s) in RCA: 768] [Impact Index Per Article: 59.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 01/17/2011] [Indexed: 01/12/2023]
Abstract
Patients with rheumatoid arthritis (RA) are at high risk of cardiovascular events. Platelet biomarkers are involved in inflammation, atherosclerosis and thrombosis. Cardiovascular and RA-associated factors can alter the structure and function of platelets, starting from megakaryocytopoiesis. Reactive megakaryocytopoiesis increases circulating platelets count and triggers hyperactivity. Hyperactive platelets target synovial membranes with subsequent local rheumatoid inflammation. Hyperactive platelets interact with other cells, and target the vascular wall. Accumulating evidence suggests that disease modifying anti-rheumatic drugs (DMARD) decrease platelet activity.
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Affiliation(s)
- Armen Yuri Gasparyan
- Department of Rheumatology, Clinical Research Unit, Russells Hall Hospital, Dudley Group of Hospitals NHS Foundation Trust (Teaching), Dudley DY1 2HQ, West Midlands, UK.
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Platelet function in rheumatoid arthritis: arthritic and cardiovascular implications. Rheumatol Int 2011; 31:153-64. [PMID: 20390282 DOI: 10.1007/s00296-010-1446-x] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 03/12/2010] [Indexed: 12/20/2022]
Abstract
Patients with rheumatoid arthritis (RA) are at high risk of cardiovascular events. Platelet biomarkers are involved in inflammation, atherosclerosis and thrombosis. Cardiovascular and RA-associated factors can alter the structure and function of platelets, starting from megakaryocytopoiesis. Reactive megakaryocytopoiesis increases circulating platelets count and triggers hyperactivity. Hyperactive platelets target synovial membranes with subsequent local rheumatoid inflammation. Hyperactive platelets interact with other cells, and target the vascular wall. Accumulating evidence suggests that disease modifying anti-rheumatic drugs (DMARD) decrease platelet activity.
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Garbaraviciene J, Diehl S, Varwig D, Bylaite M, Ackermann H, Ludwig RJ, Boehncke WH. Platelet P-selectin reflects a state of cutaneous inflammation: possible application to monitor treatment efficacy in psoriasis. Exp Dermatol 2011; 19:736-41. [PMID: 20482619 DOI: 10.1111/j.1600-0625.2010.01095.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Haemostasis-maintaining platelets are also recognized as important modulators in the regulation of immune response. Activated platelets expressing P-selectin (CD62P) are involved in the extravasation of leucocytes. This study evaluated platelet P-selectin expression as a biomarker for cutaneous inflammation. P-selectin expression was assessed by flow cytometry in 147 successive patients suffering from an inflammatory or infectious skin condition at the day of admission for in-patient treatment as well as a day prior to demission. Forty-one patients admitted for allergy testing served as controls. A commercially available ELISA was used in 17 patients to determine soluble P-selectin in the plasma. In patients with psoriasis, the Psoriasis Area and Severity Index (PASI) was documented as a measure for disease severity. We observed a significant increase in platelet P-selectin expression in patients with inflammatory or infectious disorders, when compared to the control group (3,01% vs. 1,46%; P < 0.000001). Successful treatment resulted in a significant decrease in P-selectin expression to the level of the control group. In the case of psoriasis (n = 47), we found highly significant correlation between P-selectin and PASI (r = 0.51; P < 0.000001), as well as between the change in the PASI and the change in P-selectin expression (r = 0.4; P = 0.006). Platelet P-selectin expression as determined by flow cytometry correlated well with the results of soluble P-selectin, determined by ELISA (r = 0.63; P < 0.01). Thus, platelet P-selectin expression may be used as an efficacy biomarker to monitor treatment success in psoriasis. As platelet P-selectin correlates with soluble P-selectin in patient plasma, which can be measured by ELISA, the latter is feasible also for routine use.
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Affiliation(s)
- Jurate Garbaraviciene
- Department of Dermatology, Clinic of the Goethe-University, Theodor-Stern-Kai 7, Frankfurt, Germany
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Santilli F, Davì G, Basili S, Lattanzio S, Cavoni A, Guizzardi G, De Feudis L, Traisci G, Pettinella C, Paloscia L, Minuz P, Meneguzzi A, Ciabattoni G, Patrono C. Thromboxane and prostacyclin biosynthesis in heart failure of ischemic origin: effects of disease severity and aspirin treatment. J Thromb Haemost 2010; 8:914-22. [PMID: 20180823 DOI: 10.1111/j.1538-7836.2010.03820.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
SUMMARY BACKGROUND Thromboembolism is a relatively common complication of chronic heart failure (HF) and the place of antiplatelet therapy is uncertain. OBJECTIVES We characterized the rate of thromboxane and prostacyclin biosynthesis in chronic HF of ischemic origin, with the aim of separating the influence of HF on platelet activation from that of the underlying ischemic heart disease (IHD). PATIENTS AND METHODS We compared urinary 11-dehydro-thromboxane (TX)B(2), 2,3 dinor 6-keto-PGF(1alpha,) 8-iso-prostaglandin (PG)F(2alpha), and plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP), asymmetric dimethylarginine (ADMA), and soluble CD40 ligand (sCD40L), in 84 patients with HF secondary to IHD, 61 patients with IHD without HF and 42 healthy subjects. RESULTS HF patients not on aspirin had significantly higher urinary 11-dehydro-TXB(2) as compared with healthy subjects (P < 0.0001) and IHD patients not on aspirin (P = 0.028). They also showed significantly higher 8-iso-PGF(2alpha) (P = 0.018), NT-pro-BNP (P = 0.021) and ADMA (P < 0.0001) than IHD patients not on aspirin. HF patients on low-dose aspirin had significantly lower 11-dehydro-TXB(2) (P < 0.0001), sCD40L (P = 0.007) and 2,3-dinor-6-keto-PGF(1alpha) (P = 0.005) than HF patients not treated with aspirin. HF patients in NYHA classes III and IV had significantly higher urinary 11-dehydro-TXB(2) than patients in classes I and II, independently of aspirin treatment (P < 0.05). On multiple linear regression analysis, higher NT-pro-BNP levels, lack of aspirin therapy and sCD40L, predicted 11-dehydro-TXB(2) excretion rate in HF patients (R(2) = 0.771). CONCLUSIONS Persistent platelet activation characterizes HF patients. This phenomenon is related to disease severity and is largely suppressable by low-dose aspirin. The homeostatic increase in prostacyclin biosynthesis is impaired, possibly contributing to enhanced thrombotic risk in this setting.
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Affiliation(s)
- F Santilli
- Center of Excellence on Aging, G D'Annunzio University Foundation, Chieti, Italy
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Glycoprotein VI as a prognostic biomarker for cardiovascular death in patients with symptomatic coronary artery disease. Clin Res Cardiol 2010; 99:227-33. [DOI: 10.1007/s00392-009-0109-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2009] [Accepted: 12/22/2009] [Indexed: 10/20/2022]
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Kajimoto H, Nakazawa M, Murasaki K, Hagiwara N, Nakanishi T. Increased P-Selectin Expression on Platelets and Decreased Plasma Thrombomodulin in Fontan Patients. Circ J 2009; 73:1705-10. [DOI: 10.1253/circj.cj-08-1087] [Citation(s) in RCA: 23] [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)
- Hidemi Kajimoto
- Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Women's Medical University
| | - Makoto Nakazawa
- Pediatric and Lifelong Congenital Cardiology Institute, Southern Tohoku General Hospital
| | - Kagari Murasaki
- Department of Cardiology, Heart Institute of Japan, Tokyo Women's Medical University
| | - Nobuhisa Hagiwara
- Department of Cardiology, Heart Institute of Japan, Tokyo Women's Medical University
| | - Toshio Nakanishi
- Department of Pediatric Cardiology, Heart Institute of Japan, Tokyo Women's Medical University
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