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Karakurt G, Guven O, Aynaci E, Kerget B, Senkardesler G, Duger M. Evaluation of Hemogram Parameters in the Diagnosis of Pulmonary Embolism: Immature Granulocytes and Other New Tips. Clin Appl Thromb Hemost 2024; 30:10760296241227212. [PMID: 38348584 PMCID: PMC10865945 DOI: 10.1177/10760296241227212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/03/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
Pulmonary embolism (PE) is an important cause of sudden death and is difficult to diagnose. Therefore unnecessary radiological investigations are often resorted to. Although some inflammatory parameters in the hemogram have been found to play a role in the diagnosis of PE, many parameters have not been adequately investigated. We aimed to evaluate potential inflammatory parameters in hemogram in the diagnosis of PE and to determine the parameters with the highest diagnostic value. This single-center, retrospective study was performed by evaluating 114 cases with suspected PE admitted to the emergency department between January 2017 and June 2022. Among 114 cases, 62 cases with a definitive diagnosis of PE by pulmonary computed tomography angiography served as the PE group and 52 cases without PE served as the control group. Admission hemogram parameters of both groups were recorded. Potential chronic diseases and acute conditions affecting hemogram were excluded from the study. In the multivariate model; immature granulocyte (IG), neutrophil/lymphocyte ratio (NLR), monocyte % and platelet large cell ratio (P-LCR) were found to be significantly and independently effective in differentiating cases with and without PE (P˂.05). Our findings suggest that high IG, high NLR, high monocyte %, and low P-LCR values have diagnostic value in cases with suspected PE. However the usability of IGs in the diagnosis of PE is a new finding. Hemogram is cheap, easily accessible, and potential inflammatory biomarkers in hemograms may increase physicians' awareness in the diagnosis of PE.
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Affiliation(s)
- Gokhan Karakurt
- Chest Diseases Department, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Oya Guven
- Emergency Medicine Department, Kirklareli University, Kirklareli, Turkey
| | - Engin Aynaci
- Chest Diseases Department, Beykent University, Istanbul, Turkey
| | - Bugra Kerget
- Chest Diseases Department, Ataturk University, Erzurum, Turkey
| | - Gizem Senkardesler
- Chest Diseases Department, Kirklareli Training and Research Hospital, Kirklareli, Turkey
| | - Mustafa Duger
- Chest Diseases Department, Medipol University, Istanbul, Turkey
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Abagnale L, Candia C, Motta A, Galloway B, Ambrosino P, Molino A, Maniscalco M. Flow-mediated dilation as a marker of endothelial dysfunction in pulmonary diseases: A narrative review. Respir Med Res 2023; 84:101049. [PMID: 37826872 DOI: 10.1016/j.resmer.2023.101049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/12/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
Abstract
The endothelium is an active and crucial component of vessels and produces several key regulatory factors for the homeostasis of the entire organism. Endothelial function can be investigated invasively or non-invasively, both in the coronary and peripheral circulation. A widely accepted method for the assessment of endothelial function is measurement of flow-mediated dilation (FMD), which evaluates the vascular response to changes in blood flow. In this current review, we describe FMD applications in the clinical setting of different respiratory diseases: acute SARS-COV2 infection, pulmonary embolism; post-acute SARS-COV2 infection, Chronic Obstructive Pulmonary Disease, Obstructive Sleep Apneas Syndrome, Pulmonary Hypertension, Interstitial Lung Diseases. Emerging evidence shows that FMD might be an effective tool to assess the cardiovascular risk in patients suffering from the undermentioned respiratory diseases as well as an independent predictive factor of disease severity and/or recovery.
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Affiliation(s)
- Lucia Abagnale
- Department of Medicine and Surgery, Federico II University, Naples, Italy
| | - Claudio Candia
- Department of Medicine and Surgery, Federico II University, Naples, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Naples, Italy
| | - Brurya Galloway
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, Telese Terme, Italy
| | - Pasquale Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Directorate of Telese Terme Institute, Telese Terme, Italy
| | - Antonio Molino
- Department of Medicine and Surgery, Federico II University, Naples, Italy
| | - Mauro Maniscalco
- Department of Medicine and Surgery, Federico II University, Naples, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, Telese Terme, Italy.
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Ding J, Yue X, Tian X, Liao Z, Meng R, Zou M. Association between inflammatory biomarkers and venous thromboembolism: a systematic review and meta-analysis. Thromb J 2023; 21:82. [PMID: 37525162 PMCID: PMC10388478 DOI: 10.1186/s12959-023-00526-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Venous thromboembolism (VTE) is a common thrombotic vascular disease that has a significant impact on people's well-being and quality of life. A plethora of clinical studies explore the relationship between inflammatory biomarkers and VTE but yield conflicting results. This article proposed to pool these studies to draw a more convincing conclusion. METHODS We searched several databases for studies before April 2023. Available data was processed using Stata software (version 15.0 SE) and R (version 4.1.2). This meta-analysis has been registered in PROSPERO (CRD42022321815). The VTE in this review encompassed pulmonary embolism, deep vein thrombosis, and cerebral venous thrombosis. RESULTS A total of 25 articles were finally involved in this study. Our results revealed that higher levels of high-sensitivity C-reactive protein (hs-CRP, MD, 0.63, 95%CI, 0.21-1.05) and C-reactive protein (CRP)> 3ug/ml (OR, 1.52, 95%CI, 1.18-1.96) might be regarded as risk factors for future VTE occurrence. The elevated levels of monocyte (MD, 0.03, 95%CI, 0.00-0.05), hs-CRP (0.85, 0.61-1.08), CRP (0.66, 0.20-1.13) and IL-6 (0.47, 0.25-0.70) might represent the previous VTE; a series of markers such as white blood cell (1.43, 0.88-1.98), neutrophil (1.79, 1.02-2.56), monocyte (0.17, 0.14-0.21), hs-CRP (3.72, 1.45-5.99), IL-6 (5.99, 4.52-7.46), platelet-lymphocyte ratio (33.1, 24.45-41.78) and neutrophil-lymphocyte ratio (1.34, 0.95-1.73) increased during the acute phase of VTE. CONCLUSIONS In general, activated inflammatory biomarkers might not only be correlated with an increased risk of VTE, but may also give a hint of the occurrence of VTE in clinical settings.
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Affiliation(s)
- Jiayue Ding
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Interventional Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
| | - Xuanye Yue
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
- Department of Interventional Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Xiaobing Tian
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
- Department of Interventional Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Zhangyuan Liao
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
- Department of Interventional Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ming Zou
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
- Department of Interventional Neurology, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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Wu H, Li C, Liu S, Yao S, Song Z, Ren D, Wang P. Is Neutrophil Lymphocyte Ratio, Platelet Lymphocyte Ratio or Red Blood Cell Distribution Width Associated with Risk of Mortality in Patients with Necrotizing Fasciitis. Infect Drug Resist 2023; 16:3861-3870. [PMID: 37346369 PMCID: PMC10281279 DOI: 10.2147/idr.s413126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/07/2023] [Indexed: 06/23/2023] Open
Abstract
Purpose Neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and red blood cell distribution width (RDW) are novel biomarkers to indicate the inflammatory/immune response, and demonstrated to be effective in diagnosis, severity evaluation, and prognosis in a variety of chronic or acute conditions. This study aims to examine whether NLR, PLR and EDW are independently associated with mortality in necrotizing fasciitis (NF). Methods This study retrospectively enrolled patients diagnosed with NF and based on vitality status during hospitalization or within 30 days after discharge, survival and non-survival groups were defined. For distinctly comparing NLR, PLR, RDW and others, we enrolled the matched healthy controls of the same age and sex as the survivors of NF in a 1:1 ratio, which constituted the healthy control group. Comparisons were made between three groups. Variables tested with a P value < 0.10 were further entered into the multivariate logistic regression model to identify their independent association with mortality. Results A total of 281 subjects were included, including 127 healthy controls, 127 survivors, and 27 nonsurvivors with NF, respectively, indicating a mortality rate of 17.5%. ROC analysis showed that the optimal cutoff value for NLR, PLR and RDW was 11.1, 196.0 and 15.5%, respectively, and was tested as significant only for the first two (P < 0.001, = 0.004). Multivariate logistic analysis showed that NLR ≥ 11.1 (OR, 2.51) and PLR ≥ 196.0 (OR, 2.09) were independently associated with an increased risk of mortality in NF patients, together with age ((OR, 1.28, for each 10-year increment), comorbid diabetes mellitus (OR, 2.69) and liver disease (OR, 1.86), and elevated creatinine level (OR, 1.21 for each 10 umol/L elevation). Conclusion Elevated NLR and PLR are significant and independent predictors of mortality and can be considered for use when evaluating patients at risk of mortality.
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Affiliation(s)
- Haotian Wu
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Chunxia Li
- Department of Imaging Medicine, General Hospital of Inner Mongolia Autonomous Region, Hohhot, Inner Mongolia, 010017, People’s Republic of China
| | - Song Liu
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Shuangquan Yao
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Zhaohui Song
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Dong Ren
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
| | - Pengcheng Wang
- Department of Orthopaedic Surgery, The 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, People’s Republic of China
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Sun H, Xue S, Huang Y, Zhao Y, Tian X, Gao Z, Feng G. Stratifying the risks of venous thromboembolism in the lateral skull base surgery using Caprini risk assessment model. Eur Arch Otorhinolaryngol 2023; 280:3219-3228. [PMID: 37184665 DOI: 10.1007/s00405-023-07984-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/14/2022] [Indexed: 05/16/2023]
Abstract
PURPOSE To analyze and stratify the possible risk factors of venous thromboembolism (VTE) in lateral skull base surgery (LSBS) using the Caprini risk assessment model. METHODS In a single center, a retrospective study was conducted with patients who underwent LSBS from June 2016 to August 2021. The clinical characteristics and blood chemistry tests were collected. The incidence of VTE within 30 days of surgery was recorded. The Caprini risk score was calculated to assess the postoperative VTE risk. RESULTS Among the 123 patients in this study, the VTE incidence within 30 postoperative days was 8.9%. The total Caprini risk score in VTE patients (5.6 ± 1.9 points) was significantly higher than that of non-VTE patients (4.6 ± 1.4 points; p = 0.028). The binary logistic regression showed the total Caprini score as the only independent indicator of postoperative VTE. The receiver operating characteristic curve analysis showed that the Caprini score at 6.5 points had low sensitivity (36.4%) but high specificity (91.1%), with the largest area under the curve being 0.659. The VTE rate was significantly higher in patients with a total Caprini score ≥ 7 points (28.6%) compared to those with a total Caprini score ≤ 6 points (7.3%; p = 0.022). CONCLUSION LSBS patients have a high risk of developing postoperative VTE. Patients with a Caprini score ≥ 7 points had a significantly higher risk of developing VTE after LSBS. The Caprini risk system was useful in assessing the VTE risk in LSBS. However, more data, calibration, and validation are necessary to establish an exclusive Caprini risk system for LSBS.
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Affiliation(s)
- Huiying Sun
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Songbo Xue
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Yu Huang
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Yang Zhao
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Xu Tian
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Zhiqiang Gao
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China
| | - Guodong Feng
- Department of Otorhinolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Wangfujing, DongCheng District, Beijing, 100730, China.
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Peng R, Yin W, Wang F, Cong X, Lu B, Hua L, Chen X. Neutrophil levels upon admission for the assessment of acute pulmonary embolism with intermediate- and high-risk: an indicator of thrombosis and inflammation. Thromb J 2023; 21:28. [PMID: 36918857 PMCID: PMC10015714 DOI: 10.1186/s12959-023-00471-w] [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: 11/06/2022] [Accepted: 02/21/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Risk prediction rules are important to establish appropriate treatment and management strategy for patients with different risk classification of pulmonary embolism (PE). Neutrophils are considered to be related to PE as an essential marker of inflammation. However, few studies have reported the association between neutrophil levels and risk classification of acute PE (APE). The aim of this study was to investigate the role of neutrophil levels upon admission in the assessment of risk classification of APE. METHODS A total of 299 consecutive APE patients and 90 patients without APE confirmed by computed tomographic pulmonary angiography were retrospectively screened. APE patients were stratified into two subgroups according to clinical guidelines: low- (n = 233) and intermediate- and high-risk (n = 60) APE. RESULTS The neutrophil levels in intermediate- and high-risk APE patients were significantly higher compared to low-risk APE or non-APE patients (P < 0.001). In multivariable logistic regression analysis, neutrophil levels were significantly and independently associated with intermediate- and high-risk APE (odds ratio = 1.239, 95% confidence interval [CI] 1.055-1.455, P = 0.009). Neutrophil levels were positively correlated with the pulmonary embolism severity index score (r = 0.357, P < 0.001), high sensitive C-reactive protein, D-dimer and pulmonary artery obstruction index (PAOI), in the overall population of APE patients. Receiver-operating characteristic curve analysis revealed that neutrophils had a better diagnostic value for intermediate- and high-risk APE (area under the curve [AUC] = 0.760, 95% CI 0.695-0.826; P < 0.001) compared to PAOI (AUC = 0.719) and D-dimer (AUC = 0.645). CONCLUSIONS High neutrophil levels upon admission were significantly and independently associated with intermediate- and high-risk APE, which could be regarded as an indicator of inflammation and thrombosis in APE simultaneously. The potent diagnostic role of neutrophil levels and their competitive advantage over PAOI and D-dimer for the assessment of APE risk classification are suggested.
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Affiliation(s)
- Rui Peng
- Center of Clinical Laboratory, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Diagnostic Laboratory Service, 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
| | - Weihua Yin
- Department of Radiology, 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
| | - Fang Wang
- Diagnostic Laboratory Service, 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
| | - Xiangfeng Cong
- Diagnostic Laboratory Service, 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
| | - Bin Lu
- Department of Radiology, 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
| | - Lu Hua
- Key Laboratory of Pulmonary Vascular Medicine & 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.
| | - Xi Chen
- Diagnostic Laboratory Service, 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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Kantarcioglu B, Mehrotra S, Papineni C, Siddiqui F, Kouta A, Hoppensteadt D, Bansal V, Darki A, Van Thiel DH, Fareed J. Endogenous Glycosaminoglycans in Various Pathologic Plasma Samples as Measured by a Fluorescent Quenching Method. Clin Appl Thromb Hemost 2022; 28:10760296221144047. [PMID: 36474353 PMCID: PMC9732799 DOI: 10.1177/10760296221144047] [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] [Indexed: 12/13/2022] Open
Abstract
Endogenous glycosaminoglycans (GAGs) with a similar structure to heparin are widely distributed in various tissues. A fluorescence probe, namely Heparin Red, can detect polyanionic GAGs in plasma samples. The purpose of this study is to measure endogenous GAGs in various plasma samples obtained from different pathologic states in comparison to healthy controls utilizing this method. Plasma samples were obtained from patient groups including atrial fibrillation (AF), end-stage-renal-disease (ESRD), diabetes mellitus (DM), sepsis, cancer, liver disease (LD), and pulmonary embolism (PE). Normal human plasma (NHP) was used as healthy controls. The Heparin Red kit from Red Probes (Münster, Germany) was used for the quantification of endogenous GAGs in each sample before and after heparinase I degradation. All results were compiled as group means ± SD for comparison. NHP was found to have relatively low levels of endogenous GAGs with a mean concentration of 0.06 μg/mL. The AF, ESRD, DM, and sepsis patient samples had a mean endogenous GAG concentration of 0.55, 0.72, 0.92, and 0.94 μg/mL, respectively. The levels of endogenous GAGs were highest in cancer, LD, and PE patient plasma samples with a mean concentration of 1.95, 2.78, and 2.83 μg/mL, respectively. Heparinase I degradation resulted in a decline in GAG levels in plasma samples. These results clearly show that detectable Heparin Red sensitive endogenous GAGs are present in circulating plasma at varying levels in various patient groups. Additional studies are necessary to understand this complex pathophysiology.
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Affiliation(s)
- Bulent Kantarcioglu
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA,Bulent Kantarcioglu, Department of
Pathology and Laboratory Medicine, Cardiovascular Research Institute, Loyola
University Chicago, Health Sciences Division, Maywood, IL 60153, USA.
| | - Siddharth Mehrotra
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA
| | - Charulatha Papineni
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA,Department of Molecular Pharmacology and Neuroscience,
Loyola
University Chicago, Maywood, IL, USA
| | - Fakiha Siddiqui
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA,Program in Health Sciences, UCAM - Universidad Católica San Antonio de
Murcia, Murcia, Spain
| | - Ahmed Kouta
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA,Department of Molecular Pharmacology and Neuroscience,
Loyola
University Chicago, Maywood, IL, USA
| | - Debra Hoppensteadt
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA
| | - Vinod Bansal
- Department of Internal Medicine, Nephrology,
Loyola
University Medical Center, Maywood, IL,
USA
| | - Amir Darki
- Cardiology Department, Loyola University Medical
Center, Maywood, IL, USA
| | - David H. Van Thiel
- Division of Gastroenterology and Hepatology,
Rush Oak Park
Hospital, Oak Park, Illinois and Rush
University Medical Center, Chicago, IL, USA
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine, Cardiovascular
Research Institute, Loyola
University Chicago, Health Sciences
Division, Maywood, IL, USA
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Clinical Characteristics of Patients with Pulmonary Thromboembolism Based on Computer Statistical Analysis. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1112960. [PMID: 35242294 PMCID: PMC8888095 DOI: 10.1155/2022/1112960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 02/02/2023]
Abstract
In order to explore the reliable clinical characteristics of patients with pulmonary thromboembolism, this paper applies computer statistical analysis methods to the analysis of clinical characteristics of patients with pulmonary thromboembolism. Moreover, starting from the actual situation, this paper combines experiments to study the case, uses sample screening and sample processing to group samples freely, and conducts grouping reliability research through data statistics methods. After verifying the reliability of the grouping, this paper combines the samples to test the effectiveness of the computer statistical analysis method applied to the clinical characteristic analysis of patients with pulmonary thromboembolism and conducts numerical analysis in combination with the comparative analysis method. The results of the research show that the computer statistical method proposed in this paper has a good effect on the clinical characteristics of patients with pulmonary thromboembolism and meets the actual needs of clinical analysis.
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Kantarcioglu B, Darki A, Siddiqui F, Krupa E, Vural M, Kacmaz M, Hoppensteadt D, Iqbal O, Jeske W, Walenga J, Adiguzel C, Fareed J. Predictive Role of Blood Cellular Indices and Their Relationship with Endogenous Glycosaminoglycans as Determinants of Inflammatory Biomarkers in Pulmonary Embolism. Clin Appl Thromb Hemost 2022; 28:10760296221104801. [PMID: 35733366 PMCID: PMC9234831 DOI: 10.1177/10760296221104801] [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] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION In this study, we profiled the levels of blood cellular indices, endogenous glycosaminoglycans (GAGs) and inflammatory biomarkers in a cohort comprised of pulmonary embolism (PE) patients, to determine their inter-relationships. Identification of this relationship may provide insight to the complex pathophysiology of PE and the predictive role of blood cellular indices in acute PE patients. MATERIALS AND METHODS Plasma samples from PE patients and healthy controls were analyzed for thrombo-inflammatory biomarkers (IL-2, IL-4, IL-6, IL-8, IL-10, VEGF, IFN-ɣ, TNF-α, IL-1α, IL-1β, MCP-1, EGF, D-dimer, CRP and MMP-9) using biochip array and ELISA methods. The endogenous GAG levels were quantified using a fluorescence quenching method. The data regarding the blood cellular indices were collected through the review of patient medical records and analyzed to demonstrate their relationship. RESULTS The levels of inflammatory biomarkers and endogenous GAGs were elevated in acute PE patients compared to controls (P < .05). Most of the blood cellular indices have shown significant differences in acute PE patients compared to controls (P < .05). The levels of inflammatory biomarkers, endogenous GAGs and the blood cellular indices have shown significant associations in correlation and multivariable analysis. While NLR, PLR and SII were significantly predicting the 30-day mortality, PNR, ELR and EMR were not sufficient to predict 30-day mortality in acute PE. CONCLUSION Our results show that the increased thrombo-inflammatory response is associated with the release of GAGs and the changes in blood cellular indices. The predictive role of the blood cellular indices for mortality is dependent on their relationship with the inflammatory response.
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Affiliation(s)
- Bulent Kantarcioglu
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Amir Darki
- Division of Cardiovascular Disease, Loyola Stritch School of Medicine, 25815Loyola University Medical Center, Maywood, Illinois, USA
| | - Fakiha Siddiqui
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA.,Program in Health Sciences. UCAM - Universidad Católica San Antonio de Murcia, Spain
| | - Emily Krupa
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Mehmet Vural
- Department of Internal Medicine, Loyola Stritch School of Medicine, 25815Loyola University Medical Center, Maywood, Illinois, USA.,Department of Internal Medicine, 24558Weiss Memorial Hospital, Chicago, USA
| | - Murat Kacmaz
- Department of Internal Medicine, Division of Hematology, 52987Hatay Mustafa Kemal University, Hatay, Turkey
| | - Debra Hoppensteadt
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Omer Iqbal
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Walter Jeske
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Jeanine Walenga
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
| | - Cafer Adiguzel
- Department of Internal Medicine, Division of Hematology, Bahcesehir University, Istanbul, Turkey
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine, Health Sciences Division, Cardiovascular Research Institute, 2456Loyola University Chicago, Maywood, IL, USA
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Siddiqui F, García-Ortega A, Kantarcioglu B, Sinacore J, Tafur A, Demelo-Rodríguez P, Antonio Nieto J, Usandizaga E, Fareed J, Monreal M, The Riete Investigators. Cellular Indices and Outcome in Patients with Acute Venous Thromboembolism. Clin Appl Thromb Hemost 2022; 28:10760296221113346. [PMID: 35866197 PMCID: PMC9310273 DOI: 10.1177/10760296221113346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background Cellular indices provide integrative information about systemic inflammation status which is readily available from routine laboratory parameters. This study aimed to evaluate the prognostic role of three cellular indices in patients with venous thromboembolism (VTE). Methods The RIETE registry database was used to determine the association between the baseline neutrophil-to-lymphocyte-ratio (NLR), platelet-to-lymphocyte-ratio (PLR) and systemic-immune-inflammation-index (SII) for 90-day adverse outcomes in patients with acute VTE. Results From January 2020 to April 2021, 4487 patients with acute VTE were recruited in the RIETE registry. Of these, 2683 presented with symptomatic pulmonary embolism (PE); 283 with incidental PE; 1129 with lower-limb deep vein thrombosis (DVT); 175 with upper-limb DVT; 69 with splanchnic vein thrombosis; 142 with superficial vein thrombosis and 20 with retinal vein thrombosis. Mean values were: NLR 5.9 ± 7.1, PLR 190 ± 158 and SII 1459 ± 2028. During the first 90-days, 38 patients (0.8%) developed recurrent DVT, 45 (1.0%) had recurrent PE, 152 (3.4%) suffered major bleeding, and 484 (11%) died. On multivariable analysis, patients with NLR >4.41 were at an increased risk for major bleeding and patients with NLR >4.96 were at the risk of death, while those with SII >1134.5 were at increased risk for death. Conclusions This study reports the results of a large cohort to date which evaluate the prognostic value of three cellular indices simultaneously in patients with acute VTE. Results support that none of the three baseline cellular indices were sufficient for prediction of VTE recurrences in acute VTE patients. The patients with higher baseline NLR values were at an increased risk of major bleeding or death, those with high SII values were only at an increased risk for mortality.
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Affiliation(s)
- Fakiha Siddiqui
- Department of Pathology & Laboratory Medicine, Cardiovascular Research Institute, 550858Health Science Division, 2456Loyola University Chicago, Maywood, Illinois, USA.,Program in Health Sciences, 16728UCAM - Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Alberto García-Ortega
- Respiratory Department, 16273Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Bulent Kantarcioglu
- Department of Pathology & Laboratory Medicine, Cardiovascular Research Institute, 550858Health Science Division, 2456Loyola University Chicago, Maywood, Illinois, USA
| | - James Sinacore
- Department of Public Health, 2456Loyola University Chicago, Maywood, Illinois, USA
| | - Alfonso Tafur
- Department of Medicine and Vascular Medicine, 3271Evanston NorthShore University Health System. Evanston, Illinois, USA
| | - Pablo Demelo-Rodríguez
- Department of Internal Medicine, 16483Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Antonio Nieto
- Department of Internal Medicine, 16297Hospital General Virgen de la Luz, Cuenca, Spain
| | - Esther Usandizaga
- Department of Internal Medicine, 223474Hospital Sant Joan Despí-Moises Broggi, Barcelona, Spain
| | - Jawed Fareed
- Department of Pathology & Laboratory Medicine, Cardiovascular Research Institute, 550858Health Science Division, 2456Loyola University Chicago, Maywood, Illinois, USA
| | - Manuel Monreal
- Department of Internal Medicine, 16514Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.,Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM, 16728Universidad Católica San Antonio de Murcia, Murcia, Spain
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Xue J, Ma D, Jiang J, Liu Y. Diagnostic and Prognostic Value of Immune/Inflammation Biomarkers for Venous Thromboembolism: Is It Reliable for Clinical Practice? J Inflamm Res 2021; 14:5059-5077. [PMID: 34629886 PMCID: PMC8494998 DOI: 10.2147/jir.s327014] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/19/2021] [Indexed: 12/17/2022] Open
Abstract
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), has been an important cause of sudden in-hospital death. Studies have shown that the immune/inflammatory response plays an important role in the pathogenesis of vascular disease, with representative markers in the blood including the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune/inflammatory index (SII), etc. However, there is a variety of immune/inflammatory indicators. Moreover, most previous studies have been single-center investigations involving one or two indicators, with varying nature of cases, number of cases and study objectives, thereby making it difficult to reach consensus conclusions with good clinical guidelines. This article reviews the clinical value of immunoinflammatory indicators for VTE based on previous studies, including the diagnostic and prognostic capabilities. In conclusion, NLR provides promising predictive capability for the onset and prognosis of VTE and deserves extensive application in clinical practice. PLR also has certain diagnostic and prognostic value, but further studies are warranted to identify its reliability and stability. Monocytes, eosinophils and platelet-related indicators show some clinical association with VTE, although the predictive capabilities are mediocre. SII is of promising potential value for VTE and deserves further investigations. This review will provide new clues and valuable clinical guidance for the diagnosis and therapy of VTE.
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Affiliation(s)
- Junshuai Xue
- Department of General Surgery, Vascular Surgery, Shandong University Qilu Hospital, Jinan City, Shandong Province, People's Republic of China
| | - Delin Ma
- Department of General Surgery, Shandong University Qilu Hospital, Jinan City, Shandong Province, People's Republic of China
| | - Jianjun Jiang
- Department of General Surgery, Vascular Surgery, Shandong University Qilu Hospital, Jinan City, Shandong Province, People's Republic of China
| | - Yang Liu
- Department of General Surgery, Vascular Surgery, Shandong University Qilu Hospital, Jinan City, Shandong Province, People's Republic of China
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12
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Neutrophil extracellular traps promote fibrous vascular occlusions in chronic thrombosis. Blood 2021; 137:1104-1116. [PMID: 33512471 DOI: 10.1182/blood.2020005861] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023] Open
Abstract
Acute pulmonary embolism generally resolves within 6 months. However, if the thrombus is infected, venous thrombi transform into fibrotic vascular obstructions leading to chronic deep vein thrombosis and/or chronic thromboembolic pulmonary hypertension (CTEPH), but precise mechanisms remain unclear. Neutrophils are crucial in sequestering pathogens; therefore, we investigated the role of neutrophil extracellular traps (NETs) in chronic thrombosis. Because chronic pulmonary thrombotic obstructions are biologically identical to chronic deep venous thrombi, the murine inferior vena cava ligation model was used to study the transformation of acute to chronic thrombus. Mice with staphylococcal infection presented with larger thrombi containing more neutrophils and NETs but less resolution. Targeting NETs with DNase1 diminished fibrosis and promoted thrombus resolution. For translational studies in humans, we focused on patients with CTEPH, a severe type of deep venous and pulmonary artery fibrotic obstruction after thrombosis. Neutrophils, markers of neutrophil activation, and NET formation were increased in CTEPH patients. NETs promoted the differentiation of monocytes to activated fibroblasts with the same cellular phenotype as fibroblasts from CTEPH vascular occlusions. RNA sequencing of fibroblasts isolated from thrombo-endarterectomy specimens and pulmonary artery biopsies revealed transforming growth factor-β (TGF-β) as the central regulator, a phenotype which was replicated in mice with fibroblast-specific TGF-β overactivity. Our findings uncover a role of neutrophil-mediated inflammation to enhance TGF-β signaling, which leads to fibrotic thrombus remodeling. Targeting thrombus NETs with DNases may serve as a new therapeutic concept to treat thrombosis and prevent its sequelae.
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Zhang Q, Si D, Zhang Z, Wang C, Zheng H, Li S, Huang S, Zhang W. Value of the platelet-to-lymphocyte ratio in the prediction of left ventricular thrombus in anterior ST-elevation myocardial infarction with left ventricular dysfunction. BMC Cardiovasc Disord 2020; 20:428. [PMID: 32993501 PMCID: PMC7526106 DOI: 10.1186/s12872-020-01712-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/22/2020] [Indexed: 12/23/2022] Open
Abstract
Background The predictors of left ventricular thrombus (LVT) formation are not well defined in the contemporary era, especially in those patients at high risk. We aimed to evaluate whether the platelet/lymphocyte ratio (PLR) is valuable in the determination of LVT formation in patients with anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction. Methods The LVT group (n = 46) was identified from anterior STEMI patients with LV dysfunction who were treated with primary percutaneous coronary intervention (PCI) from January 2017 to December 2019 at the China-Japan Union Hospital of Jilin University. The no-LVT group (n = 92) were also selected from the same batch of patients and were age- and sex-matched to the patients with LVT. The PLR was determined at admission and was calculated as the ratio of the platelet count to the lymphocyte count using the complete blood count. The presence of LVT was determined by echocardiography. Results The PLR were significantly higher in patients with LVT than in no-LVT group (p = 0.001). In a receiver operator characteristic curve (ROC) analysis, using a cut-off value of 118.07 (AUC 0.673, 95% CI: 0.574–0.771, P = 0.001), the PLR could independently predict the occurrence of LVT. Multivariate analysis showed that an increased PLR (OR = 1.011, 95% CI: 1.004–1.018, P = 0.002), the presence of a left ventricular aneurysm (OR = 46.350, 95% CI: 5.659–379.615, P < 0.001) and increased DTBT (OR = 1.005, 95% CI: 1.001–1.009, P = 0.012) were independent predictors of LVT formation. Conclusions In acute anterior STEMI patients with LV dysfunction, an increased PLR and DTBT and the presence of an LV aneurysm were independent predictors of LVT formation. A larger prospective study is warranted to evaluate this result. Trial registration This study was registered (May 4, 2019) on Chinese Clinical Trial Registry (ChiCTR-DDD-17011214).
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Affiliation(s)
- Qian Zhang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Daoyuan Si
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Zhongfan Zhang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Chengbing Wang
- Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Haikuo Zheng
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Shouping Li
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Shijian Huang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China
| | - Wenqi Zhang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street NO.126, Changchun, Jilin, China.
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Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are associated with cryptogenic stroke in patients with patent foramen ovale. ACTA ACUST UNITED AC 2020; 5:e112-e117. [PMID: 32529113 PMCID: PMC7277521 DOI: 10.5114/amsad.2020.95946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 04/27/2020] [Indexed: 11/17/2022]
Abstract
Introduction Although most ischaemic strokes are due to cardioembolism, about 25–40% of strokes are cryptogenic. Patent foramen ovale has been associated with cryptogenic stroke; however, the precise mechanism of this association has not been demonstrated. The aim of this study was to evaluate the association between inflammatory markers and cryptogenic stroke in patients with patent foramen ovale. Material and methods We included 206 patients with patent foramen ovale. Ninety-four (45.63%) out of 206 patients had had stroke, and 112 (54.37%) had not had stroke. The ratio of the total neutrophil count to the total lymphocyte count was defined as the neutrophil to lymphocyte ratio, and the ratio of the absolute platelet count to the absolute lymphocyte count was determined as the platelet to lymphocyte count. Results The neutrophil to lymphocyte ratio was significantly higher in patients who had stroke than in those who did not (2.41 ±1.69 vs. 2.19 ±1.74, p = 0.047). Although the platelet to lymphocyte count was also higher in patients who had had stroke than in those who had not, it was not statistically significant (120.94 ±55.45 vs. 118.01 ±52.21, p = 0.729). 1.62 was the cut-off value for neutrophil to lymphocyte ratio to be associated with stroke with 73.4% sensitivity and 45.05% specificity (p = 0.042). Conclusions This study demonstrated that elevated neutrophil to lymphocyte ratio and platelet to lymphocyte count could be associated with cryptogenic stroke in patients with patent foramen ovale.
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Sun H, Que J, Peng Y, Ye H, Xiang H, Han Y, Wang J, Ji K. The neutrophil-lymphocyte ratio: A promising predictor of mortality in coronary care unit patients - A cohort study. Int Immunopharmacol 2019; 74:105692. [PMID: 31228818 DOI: 10.1016/j.intimp.2019.105692] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 06/07/2019] [Accepted: 06/08/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Severe inflammation causes poor outcomes in coronary care unit (CCU) patients. The neutrophil-lymphocyte ratio (NLR), a biomarker used to monitor inflammation and the immune response, can predict a poor prognosis in various diseases. However, it remains unclear whether the NLR is associated with all-cause mortality in CCU patients. This study investigated the association between the NLR and CCU outcomes. METHODS Clinical data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database, which contains health data for over 50,000 patients. The primary outcome was 30-day mortality and the secondary outcome was 90-day mortality. Cox proportional hazard models were used to reveal the associations between NLR and outcomes. Multivariate analyses were used to control for confounders. RESULTS We enrolled 3563 CCU patients. For 30-day mortality, the hazard ratio (HR) (95% confidence interval [CI]) for the second (NLR 4.80-10.08) and the third (NLR ≥ 10.09) tertiles were 1.57 (1.24, 1.97) and 2.76 (2.23, 3.41), respectively, compared to the first tertile (NLR < 4.80). In the model adjusted for multiple confounders, the fifth quintile (NLR ≥ 14.17) showed a slightly lower mortality risk [HR (95% CI) 1.44 (1.07, 1.94)] compared to the fourth (NLR 8.82-14.16) [HR (95% CI) 1.55 (1.15, 2.10)]. A similar trend was observed for 90-day mortality. The interactions between the acute kidney injury, respiratory failure, and pneumonia subgroups and 30-day mortality were significant. CONCLUSIONS The NLR was an independent predictor of 30- and 90-day mortality for CCU patients. The NLR is a promising clinical biomarker as an integrated, readily available predictor of CCU mortality.
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Affiliation(s)
- Huankun Sun
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Jiaqun Que
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Yangpei Peng
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Haihao Ye
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China; Department of Cardiology, Wenzhou Hospital of Traditional Chinese Medicine, Wenzhou 325000, Zhejiang, China
| | - Huaqiang Xiang
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Yueyuan Han
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China
| | - Jie Wang
- Department of Endocrinology, Affiliated Hospital of Yanbian University, Yanji 133002, Jilin, China.
| | - Kangting Ji
- Department of Cardiology, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou 325000, Zhejiang, China.
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Yue Y, Liu S, Han X, Wang M, Li Y, Huang Q, Li B, Yang M, Dai Y, Fu Y. iTRAQ-based proteomic analysis of human umbilical vein endothelial cells with platelet endothelial aggregation receptor-1 knockdown. J Cell Biochem 2019; 120:12300-12310. [PMID: 30809853 DOI: 10.1002/jcb.28494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/13/2018] [Accepted: 01/10/2019] [Indexed: 11/06/2022]
Abstract
The disorders of hemostasis and coagulation were believed to be the main contributors to the pathogenesis of pulmonary thromboembolism (PTE), and platelets are the basic factors regulating hemostasis and coagulation and play important roles in the process of thrombosis. This study investigated the proteome of human umbilical vein endothelial cells (HUVECs) with platelet endothelial aggregation receptor-1 (PEAR1) knockdown using the isobaric tags for relative and absolute quantitation (iTRAQ) method and analyzed the role of differential abundance proteins (DAPs) in the regulation of platelets aggregation. Our results showed that the conditioned media-culturing HUVECs with PEAR1 knockdown partially suppressed the adenosine diphosphate (ADP)-induced platelet aggregation. The proteomics analysis was performed by using the iTRAQ technique, and a total of 215 DAPs (124 protein was upregulated and 91 protein were downregulated) were identified. The Gene Ontology (GO) enrichment analysis showed that proteins related to platelet α granule, adenosine triphosphate metabolic process, and endocytosis were significantly enriched. Further, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis also identified the significant enrichment of endocytosis-related pathways. The real-time polymerase chain reaction assay confirmed that the expression of P2Y12 , mitochondrial carrier 2, NADH dehydrogenase (ubiquinone) iron-sulfur protein 3, and ubiquinol-cytochrome c reductase hinge protein are significantly downregulated in the HUVECs with PEAR1 knockdown. In conclusion, our in vitro results implicated that DAPs induced by PEAR1 knockdown might contribute to the platelet aggregation. Proteomic studies by employing GO enrichment and KEGG pathway analysis suggested that the potential effects of DAPs on platelet aggregation may be linked to the balance of ADP synthesis or degradation in mitochondria.
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Affiliation(s)
- Yongjian Yue
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Shengguo Liu
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Xuemei Han
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Minlian Wang
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Yazhen Li
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Qijun Huang
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Bo Li
- Department of Pediatrics, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
| | - Mo Yang
- The Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen, Guangdong, China
| | - Yong Dai
- Clinical Medical Research Center, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, Shenzhen, Guangdong, China
| | - Yingyun Fu
- Key Laboratory of Shenzhen Respiratory Diseases, Department of Pulmonary and Critical Care Medicine, Shenzhen Institute of Respiratory Disease, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, China
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Babaei A, Pakdaman A, Hessari H, Shamshiri AR. Oral health of 6-7 year-old children according to the Caries Assessment Spectrum and Treatment (CAST) index. BMC Oral Health 2019; 19:20. [PMID: 30654779 PMCID: PMC6337759 DOI: 10.1186/s12903-018-0709-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/28/2018] [Indexed: 12/07/2022] Open
Abstract
Background The index of Caries Assessment Spectrum and Treatment (CAST) reveals a range of caries development from a non-cavitated status to advanced lesions. The aim of the present study was to explore the oral health status of 6- to 7-year-old children based on the CAST index in relation to oral health knowledge and background determinants. Methods A multi-stage cluster random sampling method was applied and after ethical clearance, clinical examination was performed (Kappa = 0.89). The status of caries and oral hygiene was recorded according to the CAST index and OHI-Simplified (OHI-S) index, respectively. A self-administered questionnaire was used to collect the data of parental knowledge of oral health. SPSS version 22.0 was used for data analysis and p-value less than 0.05 were considered significant. Results Seven hundred and thirty-nine children and their parents in 24 schools participated in this study (88%), of whom 48.6% were boys and the rest were girls. In permanent molars, a healthy status (code 0–2) was observed in 89.3–93.7% of the teeth. In primary molar teeth, dentinal lesions ranged from 25.3 to 31.2%, the prevalence of pulp involvement was between 2.9 and 10.5%, and less than 1% had abscess/fistula. Serious morbidity (codes 6 and 7) were more common in the first primary molars than the second ones. Multi-variable logistic regression analysis indicated that children with a low level of father’s education were 2.45 times more likely to have a CAST score of 3 and higher (95% CI 1.35–4.46, p = 0.003) compared to children whose fathers had academic education. For each one-unit increment of OHI_S, the likelihood of a CAST score 3 and higher in primary dentition increased by 1.77 times (OR = 1.77; 95% CI 1.08–2.93, p = 0.02). Conclusion The consequences of dental caries including abscess and fistula were more prevalent in the first and second primary teeth. There was a significant correlation between a CAST score of 3 and higher with father’s education (as an indicator of social rank) and oral hygiene status. The CAST index is a useful and practical index in epidemiological surveys. Electronic supplementary material The online version of this article (10.1186/s12903-018-0709-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Azadeh Babaei
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Postal code 1439955934, Tehran, Iran
| | - Afsaneh Pakdaman
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Postal code 1439955934, Tehran, Iran. .,Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Postal code 1417614411, Tehran, Iran.
| | - Hossein Hessari
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Postal code 1439955934, Tehran, Iran.,Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Postal code 1417614411, Tehran, Iran
| | - Ahmad R Shamshiri
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Postal code 1439955934, Tehran, Iran.,Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Postal code 1417614411, Tehran, Iran
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Urbina T, Bigé N, Nguyen Y, Boelle PY, Dubée V, Joffre J, Abdallah I, Baudel JL, Maury E, Guidet B, Ait-Oufella H. Tissue perfusion alterations correlate with mortality in patients admitted to the intensive care unit for acute pulmonary embolism: An observational study. Medicine (Baltimore) 2018; 97:e11993. [PMID: 30334938 PMCID: PMC6211900 DOI: 10.1097/md.0000000000011993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We aimed to assess the relationship between alterations of tissue perfusion parameters at admission (highly predictive of mortality in septic shock) and outcome in patients admitted to the intensive care unit (ICU) for acute pulmonary embolism (PE). We conducted a retrospective study to analyze the association between arterial lactate level, skin mottling and urinary output, and 28-day mortality.Over a 22-year period, 317 patients with PE were identified but we finally analyzed 108 patients whose main diagnosis for ICU admission was acute PE. At admission, the sequential organ failure assessment score was 2 (0-6) and the simplified acute physiology score II was 29 (16-43). Thirty patients (28%) received vasopressors and 37 patients (34%) received thrombolytic therapy. Day 28 mortality rate was 25% (n = 27). When compared to 28-day survivors, nonsurvivor patients had higher lactate level (4.5 [2.3-10.3] mmol/L vs 1.4 [1-2.9] mmol/L, P < .0001), more frequent mottling around the knee area (56% vs 25%, P = .003) and a lower urinary output (during the first 6 hours) (0.35 [0-1] mL/kg/h vs. 0.88 [0.62-1.677] mL/kg/h, P = .0002). Mortality increased with the number of tissue perfusion alterations present upon admission, 8% for none, 21% for 1, 28% for 2, and finally reached 85% for 3 tissue perfusion alterations (P < .0001). In a multivariate analysis, the relationship between the number of tissue perfusion alterations and 28-day mortality was maintained after adjustment on the presence of shock and right ventricular dilation at admission.In ICU patients admitted for acute PE, tissue perfusion alterations correlated with 28-day mortality independently of blood pressure and right ventricular dilation.
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Affiliation(s)
| | | | | | - Pierre-Yves Boelle
- Service de santé publique, Hôpital Saint-Antoine, Assistance Publique - Hôpitaux de Paris (AP-HP), Université Pierre-et-Marie
| | | | | | | | | | | | | | - Hafid Ait-Oufella
- Service de réanimation médicale
- Inserm U970, Centre de Recherche Cardiovasculaire de Paris (PARCC), Paris, France
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Poredoš P. Insufficient evidence to conclude that neutrophil-to-lymphocyte ratio predicts deep venous thrombosis. VASA 2018; 47:331-332. [PMID: 29912675 DOI: 10.1024/0301-1526/a000710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Pavel Poredoš
- 1 Department of Vascular Disease, University Medical Centre, Ljubljana, Slovenia
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Ventimiglia E, Cazzaniga W, Pederzoli F, Frego N, Chierigo F, Capogrosso P, Boeri L, Dehò F, Abbate C, Moretti D, Piemonti L, Montorsi F, Salonia A. The role of neutrophil-to-lymphocyte ratio in men with erectile dysfunction-preliminary findings of a real-life cross-sectional study. Andrology 2018; 6:559-563. [DOI: 10.1111/andr.12489] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 02/01/2018] [Accepted: 03/08/2018] [Indexed: 11/27/2022]
Affiliation(s)
- E. Ventimiglia
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - W. Cazzaniga
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - F. Pederzoli
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - N. Frego
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - F. Chierigo
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - P. Capogrosso
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - L. Boeri
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
- Department of Urology; University of Milan; Milan Italy
| | - F. Dehò
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - C. Abbate
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - D. Moretti
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - L. Piemonti
- Università Vita-Salute San Raffaele; Milan Italy
- Diabetes Research Institute; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - F. Montorsi
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - A. Salonia
- Università Vita-Salute San Raffaele; Milan Italy
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele; Milan Italy
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Ming L, Jiang Z, Ma J, Wang Q, Wu F, Ping J. Platelet-to-lymphocyte ratio, neutrophil-to-lymphocyte ratio, and platelet indices in patients with acute deep vein thrombosis. VASA 2018; 47:143-147. [PMID: 29325504 DOI: 10.1024/0301-1526/a000683] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Inflammation is associated with an increased risk of thrombotic events and complete blood count (CBC) is an easily measured test. The purpose of this study was to evaluate the value of CBC relative parameters including mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), mean platelet volume-to-lymphocyte ratio (MPVLR), and neutrophil-to-lymphocyte ratio (NLR) for patients with acute deep vein thrombosis (DVT). PATIENTS AND METHODS A total of 115 patients with unprovoked DVT of the lower extremities and 105 controls were recruited in this study. Blood samples were drawn from all participants to obtain the concentrations of CBCs and D-dimers. RESULTS MPVs (P = 0.044), PLRs (P = 0.005), MPVLRs (P = 0.001), and NLRs (P < 0.0001) were significantly higher in acute DVT patients compared to controls. The MPV was inversely correlated with platelet count (P < 0.0001) and the NLR was positively associated with D-dimers (P = 0.002) and the PLR (P < 0.0001). Notably, on multivariate logistic regression analysis, NLRs and D-dimers were independent risk factors of acute DVT (OR: 1.889, P = 0.024; OR: 1.009, P < 0.0001, respectively). CONCLUSIONS MPV, PLR, MPVLR, and NLR have potential diagnostic values for patients with unprovoked DVT. NLR is an independent risk factor related to DVT.
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Affiliation(s)
- Liang Ming
- a These authors contributed equally to this work
| | - Zhiyun Jiang
- a These authors contributed equally to this work
| | - Junfen Ma
- 1 Department of Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Qian Wang
- 1 Department of Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fan Wu
- 1 Department of Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Jiedan Ping
- 1 Department of Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Jia D, Liu F, Zhang Q, Zeng GQ, Li XL, Hou G. Rapid on-site evaluation of routine biochemical parameters to predict right ventricular dysfunction in and the prognosis of patients with acute pulmonary embolism upon admission to the emergency room. J Clin Lab Anal 2017; 32:e22362. [PMID: 29160572 DOI: 10.1002/jcla.22362] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/30/2017] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Patients with acute pulmonary embolism(APE)who present with right ventricular dysfunction (RVD) have a worse prognosis. This study aimed to evaluate the value of routine biochemical parameters in predicting RVD and 30-day mortality in patients with APE. METHODS We retrospectively collected the clinical data for 154 enrolled patients, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), D-dimer, cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP). We analyzed the correlation between RVD and the parameters and conducted a receiver operating characteristic (ROC) curve to confirm the cut-off values for predicting RVD and 30-day mortality. Formulas were built with relevant parameters to predict RVD and 30-day mortality. RESULTS Age, NLR, PLR, D-dimer, the ratio of cTnI (+), and NT-proBNP (+) were significantly higher in RVD (+) patients. The ratio of cTnI (+) and NT-proBNP (+) in 30-day mortality (+) patients was significantly higher than that in 30-day mortality (-) patients. According to the logistic regression analysis, NLR, cTnI (+), and NT-proBNP (+) correlated with RVD. The formula for the RVD risk score is 0.072 × NLR+1.460 × NT-proBNP (+)+2.113 × cTnI (+), and the area under the curve (AUC) = 0.890 (95% CI: 0.839-0.941, P = .001). The formula for the 30-day mortality risk score is 0.115 × NLR + 2.046 × NT-proBNP (+) + 1.946 × cTnI (+) -0.016 × PLR, and the AUC = 0.903 (95% CI: 0.829-0.976, P = .001). CONCLUSIONS The rapid on-site evaluation of routine biochemical parameters, including NLR, cTnI, and NT-proBNP levels, and the formula developed using these parameters are valuable for predicting RVD and 30-day mortality in patients with APE.
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Affiliation(s)
- Dong Jia
- Emergency Department, Shengjing Hospital of China Medical University, Shenyang, China.,Institute of Respiratory Disease, the First Hospital of China Medical University, Shenyang, China
| | - Fan Liu
- Institute of Respiratory Disease, the First Hospital of China Medical University, Shenyang, China
| | - Qin Zhang
- Institute of Respiratory Disease, the First Hospital of China Medical University, Shenyang, China
| | - Guang-Qiao Zeng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center of Respiratory Disease, Guangzhou Institute of Respiratory Diseases, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xue-Lian Li
- Department of Epidemiology, School of Public Health, China Medical University, Shenyang, China
| | - Gang Hou
- Institute of Respiratory Disease, the First Hospital of China Medical University, Shenyang, China
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Meng X, Chang Q, Liu Y, Chen L, Wei G, Yang J, Zheng P, He F, Wang W, Ming L. Determinant roles of gender and age on SII, PLR, NLR, LMR and MLR and their reference intervals defining in Henan, China: A posteriori and big-data-based. J Clin Lab Anal 2017; 32. [PMID: 28378887 DOI: 10.1002/jcla.22228] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/07/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES By now, there are few data of the reference intervals (RIs) of SII, PLR, NLR, LMR and MLR. We aimed to establish RIs of SII, PLR, NLR, LMR and MLR for healthy persons. METHODS A retrospective analysis on a cohort of ostensibly healthy, aged no <18 years old physical examinees who took health examination from January to December in 2013 was conducted to explore influences of age and gender on SII, PLR, NLR, LMR and MLR and to establish their RIs. And another cohort of 450 persons in our hospital from January to July in 2016 is included for validations of RIs. RESULTS NLR, LMR and MLR were significantly different between gender groups (P=.010; P<.001; P<.001, separately), while SII and PLR were not (P=.137; P=.267, separately). While SII was not changed much between age groups (P=.842), PLR, NLR, LMR and MLR were significantly different (all with P<.001). RIs of SII, PLR, NLR, LMR and MLR were: SII: [161,701]; PLR: 18-65 year-old: [61,179]/>65 year-old: [55,179]; NLR: 18-65 year-old male: [0.90,2.94]/18-65 year-old female: [0.85,3.06]/>65 year-old male: [0.95,3.57]/aged >65 year-old female: [0.83,3.30]; LMR: 18-65 year-old male: [2.50,7.50]/18-65 year-old female: [2.75,8.50]/>65 year-old male: [2.16,7.41]/>65 year-old female: [2.40,8.33]; MLR: 18-65 year-old male: [0.12,0.35]/18-65 year-old female: [0.10,0.32]/>65 year-old male: [0.12,0.41]/>65 year-old male: [0.11,0.33]. CONCLUSIONS RIs of SII, PLR, NLR, LMR and MLR of people in central China were established and validated. It will benefit experimental design of the related studies and lead to better standardizations of SII, PLR, NLR, LMR and MLR for their clinical applications.
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Affiliation(s)
- Xianchun Meng
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Qian Chang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Yuying Liu
- Physical Examination Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ling Chen
- Clinical Laboratory, People's Hospital of Jiangyou, Mianyang, Sichuan, China
| | - Gaohui Wei
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Jingjing Yang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Peiguo Zheng
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Fucheng He
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Wanhai Wang
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
| | - Liang Ming
- Clinical Laboratory, First Affiliated Hospital of Zhengzhou University, Key Laboratory of Laboratory Medicine of Henan Province, Zhengzhou, Henan, China
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Buyukterzi Z, Buyukterzi M, Kurtipek E, Alpaydin MS, Karaarslan S. Subclinical Atherosclerosis in Patients with Prior Pulmonary Thromboembolism. Med Princ Pract 2017; 26:321-324. [PMID: 28380485 PMCID: PMC5768129 DOI: 10.1159/000475466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 04/04/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Recent studies have indicated that endothelial dysfunction is common in patients with a prior history of pulmonary thromboembolism (PTE). Based on the established relationship between endothelial dysfunction and atherosclerosis, we aimed to investigate carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in patients who have a prior history of PTE. SUBJECTS AND METHODS Medical records belonging to patients with a history of PTE and age- and gender-matched control subjects among those who underwent transthoracic echocardiography in Konya Training and Research Hospital were reviewed. Echocardiographic findings and cIMT measurements were recorded. cIMT measurements were compared between patient and control groups, and then independent correlates of cIMT were investigated using appropriate statistical methods. RESULTS A total of 110 patients (64.02 ± 12.67 years, males: n = 79 [71.81%]; females: n = 31 [28.19%]) were found to be eligible for assessment. Of these patients, 55 (50.00%) had a history of PTE. Patients with a history of PTE had significantly greater cIMT (p = 0.040). In this group of patients, cIMT positively and significantly correlated with basal right ventricular (RV) diameter (r = 0.271, p = 0.022), RV diastolic area (r = 0.376, p = 0.002), and systolic pulmonary artery pressure (r = 0.248, p = 0.037). In the multivariate linear regression analysis, only RV diastolic area was independently associated with cIMT in patients with PTE (p = 0.010). CONCLUSION Patients with a history of PTE have increased cIMT when compared to healthy subjects, and cIMT, which is a marker of subclinical atherosclerosis, is independently associated with RV diameter in these patients.
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Affiliation(s)
- Zafer Buyukterzi
- Department of Cardiology, Konya Training and Research Hospital, Konya, Turkey
- *Zafer Buyukterzi, MD, Department of Cardiology, Konya Training and Research Hospital, TR-42090 Konya, Meram (Turkey), E-Mail
| | - Meral Buyukterzi
- Department of Radiology, Konya Training and Research Hospital, Konya, Turkey
| | - Ercan Kurtipek
- Department of Chest Diseases, Konya Training and Research Hospital, Konya, Turkey
| | | | - Sukru Karaarslan
- Department of Cardiology, Konya Training and Research Hospital, Konya, Turkey
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Ma Y, Mao Y, He X, Sun Y, Huang S, Qiu J. The values of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in predicting 30 day mortality in patients with acute pulmonary embolism. BMC Cardiovasc Disord 2016; 16:123. [PMID: 27259553 PMCID: PMC4893291 DOI: 10.1186/s12872-016-0304-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 05/30/2016] [Indexed: 11/28/2022] Open
Abstract
Background vAcute pulmonary embolism (PE) is a life threatening disease. The treatment options depend on the severity of the disease and the mortality varies widely depending on the severity of the condition. It is important to identify patients who are at high risk of mortality. The aim of the present study was to explore the prognostic alues of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) for 30-day mortality in patients with acute PE. Methods The study included 321 patients admitted to our university hospital between January 2013 and May 2015 with the diagnosis of acute PE. Multivariable risk models were developed to assess the predictive values of the NLR and PLR for 30-day mortality. Discrimination was evaluated using receiver operating characteristic (ROC) curves. Results Two hundred forty-eight patients met our selection criteria. Twenty of them died within 30 days of hospital admission. NLR was found to be an independent predicator after other confounding factors were adjusted in the model. For 1 unit of increase of NLR, the risk of 30-day mortality rose about 13 % (OR = 1.13,95 % CI: 1.04–1.23). The area under ROC for NLR is 0.79 (95 %CI: 0.703–0.880). PLR was associated with 30-day mortality in univariate analysis but the predicative ability diminished with inclusion of other predicators in multivariable model. Conclusions NLR is readily available predicator for short-term mortality. It could be a useful indicator for identifying high risk population and guiding clinical management of acute PE.
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Affiliation(s)
- Yaqing Ma
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China
| | - Yimin Mao
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China.
| | - Xuegai He
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China
| | - Yuxia Sun
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China
| | - Shenshen Huang
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China
| | - Jiayong Qiu
- Department of Respiratory Medicine, The First Affiliated Hospital, and College of Clinical Medicine of Henan University of Science and Technology, 471003, Luoyang, China
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