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Cui Y, Jiang X, Yang M, Yuan Y, Zhou Z, Gao X, Jia G, Cao L, Li D, Zhao Y, Zhang X, Zhao G. SEMA4D/VEGF surface enhances endothelialization by diminished-glycolysis-mediated M2-like macrophage polarization. Mater Today Bio 2023; 23:100832. [PMID: 38024840 PMCID: PMC10630656 DOI: 10.1016/j.mtbio.2023.100832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/20/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Cardiovascular disease remains the leading cause of death and morbidity worldwide. Inflammatory responses after percutaneous coronary intervention led to neoathrosclerosis and in-stent restenosis and thus increase the risk of adverse clinical outcomes. In this work, a metabolism reshaped surface is engineered, which combines the decreased glycolysis promoting, M2-like macrophage polarization, and rapid endothelialization property. Anionic heparin plays as a linker and mediates cationic SEMA4D and VEGF to graft electronically onto PLL surfaces. The system composed by anticoagulant heparin, immunoregulatory SEMA4D and angiogenic VEGF endows the scaffold with significant inhibition of platelets, fibrinogen and anti-thrombogenic properties, also noteworthy immunometabolism reprogram, anti-inflammation M2-like polarization and finally leading to rapid endothelializaiton performances. Our research indicates that the immunometabolism method can accurately reflect the immune state of modified surfaces. It is envisioned immunometabolism study will open an avenue to the surface engineering of vascular implants for better clinical outcomes.
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Affiliation(s)
- Yuanyuan Cui
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xiaomei Jiang
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Maozhu Yang
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Yinglin Yuan
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Zili Zhou
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Xiang Gao
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Guiqing Jia
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Lvzhou Cao
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Danni Li
- Department of Pharmacy, Longquanyi District of Chengdu Maternity & Child Health Care Hospital, Chengdu, 610072, China
| | - Yanshuang Zhao
- Department of Pharmacy, The People's Hospital of Leshan, Leshan, China
| | - Xin Zhang
- School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Gaoping Zhao
- Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
- Clinical Immunology Translational Medicine Key Laboratory of Sichuan Province, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, China
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Lokhov PG, Balashova EE, Trifonova OP, Maslov DL, Grigoriev AI, Ponomarenko EA, Archakov AI. Mass Spectrometric Blood Metabogram: Acquisition, Characterization, and Prospects for Application. Int J Mol Sci 2023; 24:ijms24021736. [PMID: 36675249 PMCID: PMC9861083 DOI: 10.3390/ijms24021736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/04/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
In metabolomics, many metabolites are measured simultaneously in a single run. Such analytical performance opens up prospects for clinical laboratory diagnostics. In this work, a mass spectrometric metabogram was developed as a simplified and clinically applicable way of measuring the blood plasma metabolome. To develop the metabogram, blood plasma samples from healthy male volunteers (n = 48) of approximately the same age, direct infusion mass spectrometry (DIMS) of the low molecular fraction of samples, and principal component analysis (PCA) of the mass spectra were used. The seven components of the metabogram defined by PCA, which cover ~70% of blood plasma metabolome variability, were characterized using a metabolite set enrichment analysis (MSEA) and clinical test results of participating volunteers. It has been established that the components of the metabogram are functionally related groups of the blood metabolome associated with regulation, lipid-carbohydrate, and lipid-amine blood components, eicosanoids, lipid intake into the organism, and liver function thereby providing a lot of clinically relevant information. Therefore, metabogram provides the possibility to apply the metabolomics performance in the clinic. The features of the metabogram are also discussed in comparison with the thin-layer chromatography and with the analysis of blood metabolome by liquid chromatography combined with mass spectrometry.
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Affiliation(s)
- Petr G. Lokhov
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
- Correspondence:
| | - Elena E. Balashova
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Oxana P. Trifonova
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Dmitry L. Maslov
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Anatoly I. Grigoriev
- Institute of Biomedical Problems, Russian Federation State Scientific Research Center, Russian Academy of Sciences, 123007 Moscow, Russia
| | - Elena A. Ponomarenko
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
| | - Alexander I. Archakov
- Institute of Biomedical Chemistry, 10 Building 8, Pogodinskaya Street, 119121 Moscow, Russia
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Nazeri M, Chamanara M, Yousefi Zoshk M, Aghsami M, Noroozi Aghide A, Khajeh-Amiri A, Nassireslami E. Design, Docking Study, Synthesis, and Platelet Aggregometry Assay of Novel N'-Benzylidene-7-(4-Methoxyphenyl)-2,4-Dioxo-1,2,3,4-Tetrahydropyrido[2,3-d]Pyrimidine-5-Carbohydrazide Derivatives as Antiplatelet Agents. Polycycl Aromat Compd 2022. [DOI: 10.1080/10406638.2022.2041679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Mohamad Nazeri
- Department of Pharmacology and Toxicology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mohsen Chamanara
- Department of Pharmacology and Toxicology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mojtaba Yousefi Zoshk
- AJA University of Medical Sciences, Tehran, Iran
- Trauma Research Center, AJA University of Medical Sciences, Tehran, Iran
| | - Mehdi Aghsami
- Department of Pharmacology and Toxicology, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Ehsan Nassireslami
- Department of Pharmacology and Toxicology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
- Toxicology Research Center, AJA University of Medical Sciences, Tehran, Iran
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4
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Fibrinolysis Index as a new predictor of deep vein thrombosis after traumatic lower extremity fractures. Clin Chim Acta 2020; 511:227-234. [PMID: 33080260 DOI: 10.1016/j.cca.2020.10.018] [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: 08/12/2020] [Revised: 10/14/2020] [Accepted: 10/14/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Deep vein thrombosis (DVT) is a common complication in patients with traumatic injury. The purpose of this study was to develop a potential predictor of DVT. METHODS This case-control study enrolled adult trauma patients and healthy volunteers. Patients underwent angiography before surgery to diagnose DVT. Patients with or without DVT were matched by gender, age and fracture sites. Laboratory parameters included lysis potential (LP), lysis time (LT), blood cell counts, conventional coagulation tests, tissue plasminogen activator inhibitor complex (tPAIC) and others. RESULTS 41 of 319 patients with DVT were matched with 41 patients without DVT and 80 healthy volunteers were controls. LP and LT were significantly decreased in patients with DVT than without (P = 0.043 and P = 0.014, respectively). The level of tPAIC in the DVT group was significantly higher than in patients without DVT (P = 0.042). We defined the Fibrinolysis Index as (-10.707) × LP + (-0.607) × LT (min) + 0.012 × fibrinogen (mg/dl) + 0.299 × tPAIC (ng/ml) + 9.917, and found that the area under the receiver operating characteristic curve for the Fibrinolysis Index was 0.802, making it a novel indicator. CONCLUSION The Fibrinolysis Index represents a new discriminator for predicting DVT after traumatic lower extremity fractures.
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Deveci B, Gazi E. Relation Between Globulin, Fibrinogen, and Albumin With the Presence and Severity of Coronary Artery Disease. Angiology 2020; 72:174-180. [PMID: 32996325 DOI: 10.1177/0003319720959985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The albumin to globulin ratio (AGR) is used as a prognostic marker in acute ischemic cardiovascular events. We investigated whether serum AGR, fibrinogen, and fibrinogen to albumin ratio (FAR) are related to the presence and severity of coronary artery disease (CAD). Patients who underwent coronary angiography procedures were analyzed retrospectively. The severity of CAD was assessed by the Gensini score. The study population (3031 patients; 1071 females and 1960 males) was divided into 3 tertiles based on AGR values. Gensini score, lipid levels, diabetes mellitus (DM), hypertension (HT), age, and fibrinogen level were higher in the low AGR group. Pearson correlation analysis showed that AGR (r = -0.068, P < .001) was negatively and fibrinogen (r = 0.187, P < .001) was positively correlated with the Gensini score. Male gender, HT, smoking, DM, age, high triglyceride (TG) level, low-density lipoprotein cholesterol (LDL-C) >160 mg/dL, estimated glomerular filtration rate (eGFR) <60 mL/min, and fibrinogen level >3.5 g/L were independent predictors of CAD. Male gender, age, eGFR, DM, LDL-C, TG, and FAR had an independent positive relation to the Gensini score. In conclusion, similar to traditional risk factors, plasma fibrinogen and albumin levels showed a close relation with the presence and severity of CAD.
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Affiliation(s)
- Bülent Deveci
- Department of Cardiology, 448249Sağlık Bilimleri University, Ankara, Turkey
| | - Emine Gazi
- Department of Cardiology, 52950Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature. Diagnostics (Basel) 2020; 10:diagnostics10080567. [PMID: 32784640 PMCID: PMC7460223 DOI: 10.3390/diagnostics10080567] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 07/29/2020] [Accepted: 08/05/2020] [Indexed: 01/01/2023] Open
Abstract
The presence of endometriosis determines an inflammatory response locally. The objective of this validation study and systematic review was to assess systemic levels of coagulation and inflammatory parameters in women with or without the disease. We conducted a retrospective analysis of a database prospectively collected from January 2017 to February 2020 including n = 572 women who underwent laparoscopic surgery for endometriosis (cases, n = 324) or other benign gynecologic diseases (controls, n = 248). Inflammatory markers and coagulation parameters were determined. An advanced systematic search of the literature on the same parameters was conducted up to April 2020. A significantly higher neutrophil count was found in endometriosis patients. Patients with endometriomas and stage III–IV disease had a significantly lower absolute lymphocyte count and shortened activated partial thromboplastin time (aPTT) values. In the final regression model, aPTT retained significant predictive value for stage III–IV endometriosis (odds ratio (OR) = 0.002, 95% confidence interval (CI) = 0.00–0.445; p = 0.024). Results from the n = 14 included studies in the systematic review are characterized by a high variability, but some consistency has been found for alterations in thrombin time, platelet-to-lymphocyte ratio, and neutrophil count associated with endometriosis. Modest systemic changes of some inflammatory and coagulation parameters are associated with endometriosis. Indeed, all the modifications detected are still within the normal reference intervals, explaining the high heterogeneity among studies.
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Wang C, Li G, Liang X, Qin C, Luo Q, Song R, Chen W. Predictive Value of Fibrinogen-to-Albumin Ratio for Post-Contrast Acute Kidney Injury in Patients Undergoing Elective Percutaneous Coronary Intervention. Med Sci Monit 2020; 26:e924498. [PMID: 32684616 PMCID: PMC7757022 DOI: 10.12659/msm.924498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Post-contrast acute kidney injury (PC-AKI) is a contributor to adverse outcomes after percutaneous coronary intervention (PCI). This study aimed to investigate whether fibrinogen-to-albumin ratio (FAR), a novel inflammation-based risk index, can predict the occurrence of PC-AKI in patients undergoing elective PCI. MATERIAL AND METHODS We retrospectively enrolled 291 patients who underwent elective PCI from June 2017 to June 2019. PC-AKI was defined as an increase in serum creatinine ≥0.3 mg/dL (≥26.5 μmol/L), or ≥1.5 times baseline within 48 to 72 hours after PCI. The area under the receiver-operating characteristic curve (AUC), continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to make comparison for PC-AKI prediction. RESULTS PC-AKI occurred in 43 patients (14.8%). FAR showed an AUC of 0.691 (95% confidence interval: 0.64-0.74; P<0.001) in predicting PC-AKI. In stepwise multivariable logistic regression, FAR was independently associated with the occurrence of PC-AKI along with hypertension, diabetes, hemoglobin, estimated glomerular filtration rate, and left ventricular ejection fraction. FAR significantly improved PC-AKI prediction over Mehran risk score in the continuous NRI and IDI, but not AUC. CONCLUSIONS FAR is independently associated with the occurrence of PC-AKI, and can significantly improve PC-AKI prediction over Mehran risk score in patients undergoing elective PCI.
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Affiliation(s)
- Can Wang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Gaoye Li
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiaomei Liang
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Chunyu Qin
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Qiuhu Luo
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Rui Song
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Wuxian Chen
- Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
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Polat N, Oylumlu M, Işik MA, Arslan B, Özbek M, Demir M, Kaya H, Toprak N. Prognostic Significance of Serum Albumin in Patients With Acute Coronary Syndrome. Angiology 2020; 71:903-908. [DOI: 10.1177/0003319720941747] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In patients with unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI), long-term mortality remains high despite improvements in the diagnosis and treatment. In this study, we investigated whether serum albumin level is a useful predictor of long-term mortality in patients with UAP/NSTEMI. Consecutive patients (n = 403) who were hospitalized with a diagnosis of UAP/NSTEMI were included in the study. Patients were divided into 2 groups based on the presence of hypoalbuminemia and the relationship between hypoalbuminemia and mortality was analyzed. Hypoalbuminemia was detected in 34% of the patients. The median follow-up period was 35 months (up to 45 months). Long-term mortality rate was 32% in the hypoalbuminemia group and 8.6% in the group with normal serum albumin levels ( P < .001). On multivariate analysis, hypoalbuminemia, decreased left ventricular ejection fraction, and increased age were found to be independent predictors of mortality ( P < .05). The cutoff value of 3.10 g/dL for serum albumin predicted mortality with a sensitivity of 74% and specificity of 67% (receiver-operating characteristic area under curve: 0.753, 95% CI: 0.685-0.822). All-cause long-term mortality rates were significantly increased in patients with hypoalbuminemia. On-admission albumin level was an independent predictor of mortality in patients with UAP/NSTEMI.
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Affiliation(s)
- Nihat Polat
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mustafa Oylumlu
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Ali Işik
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Bayram Arslan
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Mehmet Özbek
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Muhammed Demir
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Hasan Kaya
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
| | - Nizamettin Toprak
- Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey
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Takahashi A, Takahashi S, Tsujino T, Isobe K, Watanabe T, Kitamura Y, Watanabe T, Nakata K, Kawase T. Platelet adhesion on commercially pure titanium plates in vitro I: effects of plasma components and involvement of the von Willebrand factor and fibronectin. Int J Implant Dent 2019; 5:5. [PMID: 30799507 PMCID: PMC6387980 DOI: 10.1186/s40729-019-0160-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/14/2019] [Indexed: 12/13/2022] Open
Abstract
Background Platelet-rich plasma (PRP) is widely used in regenerative dentistry. Furthermore, it is often applied in the pretreatment of titanium implants to improve their surface bioaffinity and initial stability. However, effects of PRP application on implant surface at cellular and molecular levels remain poorly understood. Therefore, we examined platelet adhesion on commercially pure titanium (cp-Ti) plates, with a particular focus on fibrinogen (FGN), von Willebrand factor (vWF), and fibronectin (FN), in the presence or absence of plasma components. Methods Citrated blood samples were obtained from six healthy male volunteers, and pure-PRP (P-PRP) and pure platelet suspensions in phosphate-buffered saline (PBS) were prepared. Platelet adhesion on cp-Ti plate surface was evaluated by phalloidin staining and tetrazolium dye assay. Distribution of FGN, vWF, FN, albumin, CD62P, and CD63 was examined by immunocytochemical analysis. Results Platelets in PBS suspensions rapidly and time-dependently adhered to cp-Ti plate surface, but this adhesion was substantially disturbed by the presence of plasma components. FGN was most preferably adsorbed regardless of the presence or absence of plasma components, while vWF and FN showed greater accumulation on platelet adhesion area. Conclusions Although FGN is rapidly and abundantly adsorbed on cp-Ti plate surface, vWF and FN function as major platelet adhesion molecules in citrated blood samples. After pretreatment with P-PRP, however, platelets adhered to cp-Ti much less efficiently. Therefore, P-PRP pretreatment might not directly contribute to surface functionalization, initial stabilization, and osseointegration of machined or similar types of implants. Electronic supplementary material The online version of this article (10.1186/s40729-019-0160-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | | | - Taisuke Watanabe
- Division of Anatomy and Cell Biology of the Hard Tissue, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan
| | - Yutaka Kitamura
- Department of Oral and Maxillofacial Surgery, Matsumoto Dental University, Shiojiri, Japan
| | - Takao Watanabe
- Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Koh Nakata
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Tomoyuki Kawase
- Division of Oral Bioengineering, Institute of Medicine and Dentistry, Niigata University, Niigata, Japan.
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Ward-Caviness CK, de Vries PS, Wiggins KL, Huffman JE, Yanek LR, Bielak LF, Giulianini F, Guo X, Kleber ME, Kacprowski T, Groß S, Petersman A, Davey Smith G, Hartwig FP, Bowden J, Hemani G, Müller-Nuraysid M, Strauch K, Koenig W, Waldenberger M, Meitinger T, Pankratz N, Boerwinkle E, Tang W, Fu YP, Johnson AD, Song C, de Maat MPM, Uitterlinden AG, Franco OH, Brody JA, McKnight B, Chen YDI, Psaty BM, Mathias RA, Becker DM, Peyser PA, Smith JA, Bielinski SJ, Ridker PM, Taylor KD, Yao J, Tracy R, Delgado G, Trompet S, Sattar N, Jukema JW, Becker LC, Kardia SLR, Rotter JI, März W, Dörr M, Chasman DI, Dehghan A, O’Donnell CJ, Smith NL, Peters A, Morrison AC. Mendelian randomization evaluation of causal effects of fibrinogen on incident coronary heart disease. PLoS One 2019; 14:e0216222. [PMID: 31075152 PMCID: PMC6510421 DOI: 10.1371/journal.pone.0216222] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 04/16/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Fibrinogen is an essential hemostatic factor and cardiovascular disease risk factor. Early attempts at evaluating the causal effect of fibrinogen on coronary heart disease (CHD) and myocardial infraction (MI) using Mendelian randomization (MR) used single variant approaches, and did not take advantage of recent genome-wide association studies (GWAS) or multi-variant, pleiotropy robust MR methodologies. METHODS AND FINDINGS We evaluated evidence for a causal effect of fibrinogen on both CHD and MI using MR. We used both an allele score approach and pleiotropy robust MR models. The allele score was composed of 38 fibrinogen-associated variants from recent GWAS. Initial analyses using the allele score used a meta-analysis of 11 European-ancestry prospective cohorts, free of CHD and MI at baseline, to examine incidence CHD and MI. We also applied 2 sample MR methods with data from a prevalent CHD and MI GWAS. Results are given in terms of the hazard ratio (HR) or odds ratio (OR), depending on the study design, and associated 95% confidence interval (CI). In single variant analyses no causal effect of fibrinogen on CHD or MI was observed. In multi-variant analyses using incidence CHD cases and the allele score approach, the estimated causal effect (HR) of a 1 g/L higher fibrinogen concentration was 1.62 (CI = 1.12, 2.36) when using incident cases and the allele score approach. In 2 sample MR analyses that accounted for pleiotropy, the causal estimate (OR) was reduced to 1.18 (CI = 0.98, 1.42) and 1.09 (CI = 0.89, 1.33) in the 2 most precise (smallest CI) models, out of 4 models evaluated. In the 2 sample MR analyses for MI, there was only very weak evidence of a causal effect in only 1 out of 4 models. CONCLUSIONS A small causal effect of fibrinogen on CHD is observed using multi-variant MR approaches which account for pleiotropy, but not single variant MR approaches. Taken together, results indicate that even with large sample sizes and multi-variant approaches MR analyses still cannot exclude the null when estimating the causal effect of fibrinogen on CHD, but that any potential causal effect is likely to be much smaller than observed in epidemiological studies.
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Affiliation(s)
- Cavin K. Ward-Caviness
- Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- * E-mail:
| | - Paul S. de Vries
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, United States of America
| | - Kerri L. Wiggins
- Department of Medicine, University of Washington, Health Sciences Bldg, Seattle, Washington, United States of America
| | - Jennifer E. Huffman
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA, United States of America
- The Framingham Heart Study, Framingham, MA, United States of America
| | - Lisa R. Yanek
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Broadway, Baltimore, MD, United States of America
| | - Lawrence F. Bielak
- Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Franco Giulianini
- Division of Preventative Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Xiuqing Guo
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Marcus E. Kleber
- Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
- Institute of Nutrition, Friedrich-Schiller University Jena, Jena, Germany
| | - Tim Kacprowski
- Department of Functional Genomics, Interfaculty Institute for Genetics and Functional Genomics, University Medicine and Ernst-Moritz-Arndt University Greifswald, Griefswald, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Research Group Computational Systems Medicine, Chair of Experimental Bioinformatics, TUM School of Life Sciences, Technical University of Munich, Freising-Weihenstephan, Germany
| | - Stefan Groß
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Astrid Petersman
- Institute of Clinical Chemistry and Laboratory Medicine, University of Medicine Griefswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - George Davey Smith
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Fernando P. Hartwig
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Jack Bowden
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Gibran Hemani
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Martina Müller-Nuraysid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
| | - Konstantin Strauch
- Institute of Genetic Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Department of Medicine I, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Chair of Genetic Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
| | - Wolfgang Koenig
- DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Department of Internal Medicine II, University of Ulm Medical Center, Ulm, Germany
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Melanie Waldenberger
- Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Research Unit of Molecular Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
| | - Thomas Meitinger
- DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Institute of Human Genetics, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- Institute of Human Genetics, Technische Universität München, Munich, Germany
| | - Nathan Pankratz
- University of Minnesota School of Medicine, Minneapolis, MN, United States of America
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, United States of America
- Human Genome Sequencing Center, Baylor College of Medicine, One Baylor Plaza, Houston, United States of America
| | - Weihong Tang
- University of Minnesota School of Public Health, Minneapolis, MN, United States of America
| | - Yi-Ping Fu
- Office of Biostatistics Research, Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States of America
| | - Andrew D. Johnson
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA, United States of America
- The Framingham Heart Study, Framingham, MA, United States of America
| | - Ci Song
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA, United States of America
- The Framingham Heart Study, Framingham, MA, United States of America
| | - Moniek P. M. de Maat
- Department of Hematology, Erasmus University Medical Center, Rotterdam, CND, Netherlands
| | - André G. Uitterlinden
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, CN, Netherlands
| | - Oscar H. Franco
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Jennifer A. Brody
- Department of Medicine, University of Washington, Health Sciences Bldg, Seattle, Washington, United States of America
| | - Barbara McKnight
- Department of Biostatistics, University of Washington, Health Sciences Bldg, Seattle, WA, United States of America
| | - Yii-Der Ida Chen
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Bruce M. Psaty
- Department of Medicine, University of Washington, Health Sciences Bldg, Seattle, Washington, United States of America
- Department of Epidemiology, University of Washington, Health Sciences Bldg, Seattle, WA, United States of America
- Department of Health Services, University of Washington, Health Sciences Bldg, Seattle, WA, United States of America
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, United States of America
| | - Rasika A. Mathias
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Broadway, Baltimore, MD, United States of America
- Division of Allergy and Clinical Immunology, Department of Medicine, Johns Hopkins University School of Medicine, N. Broadway, Baltimore, MD, United States of America
| | - Diane M. Becker
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Broadway, Baltimore, MD, United States of America
| | - Patricia A. Peyser
- Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jennifer A. Smith
- Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Suzette J. Bielinski
- Department of Epidemiology, Mayo Clinic, Rochester, MN, United States of America
| | - Paul M. Ridker
- Division of Preventative Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Kent D. Taylor
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Jie Yao
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Russell Tracy
- Pathology and Laboratory Medicine, The University of Vermont College of Medicine, Col Research Facility, Burlington, VT, United States of America
| | - Graciela Delgado
- Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stella Trompet
- Department of Hematology, Erasmus University Medical Center, Rotterdam, CND, Netherlands
- Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Naveed Sattar
- BHF Glasgow Cardiovascular Research Centre, Faculty of Medicine, Glasgow, United Kingdom
| | - J. Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Lewis C. Becker
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Broadway, Baltimore, MD, United States of America
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, N. Broadway, Baltimore, MD, United States of America
| | - Sharon L. R. Kardia
- Epidemiology, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Jerome I. Rotter
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - Winfried März
- Vth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, University of Heidelberg, Mannheim, Germany
- Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Marcus Dörr
- DZHK (German Centre for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, Greifswald, Germany
| | - Daniel I. Chasman
- Division of Preventative Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
- Department of Epidemiology and Biostatistics, Imperial College London, Norfolk Place, London, United Kingdom
| | - Christopher J. O’Donnell
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Framingham, MA, United States of America
- Cardiology Section Administration, Boston VA Healthcare System, West Roxbury, MA, United States of America
| | - Nicholas L. Smith
- Department of Epidemiology, University of Washington, Health Sciences Bldg, Seattle, WA, United States of America
- Group Health Research Institute, Group Health Cooperative, Seattle, WA, United States of America
- Seattle Epidemiologic Research and Information Center, Department of Veteran Affairs Office of Research and Development, Columbian Way, Seattle, WA, United States of America
| | - Annette Peters
- Epidemiology II, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany
- DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Alanna C. Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, Houston, United States of America
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11
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Smith L, Chakraborty D, Bhattacharya P, Sarmah D, Koch S, Dave KR. Exposure to hypoglycemia and risk of stroke. Ann N Y Acad Sci 2018; 1431:25-34. [PMID: 29917249 DOI: 10.1111/nyas.13872] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/23/2018] [Accepted: 05/08/2018] [Indexed: 12/25/2022]
Abstract
In the treatment of both type 1 and type 2 diabetes mellitus, maintaining a euglycemic state represents one of the key challenges. Improper dosing and administration of glucose-lowering drugs is associated with an increased risk of recurrent hypoglycemia episodes. In addition, the risk of adverse cardiovascular events in diabetic patients, particularly myocardial infarctions and strokes, is well established. Current research indicates a potential link between the baseline risk of cardio/cerebrovascular events in diabetic patients and exposure to hypoglycemia. In this review of the literature, we aim to determine if a relationship exists between recurrent hypoglycemia and adverse neurovascular events.
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Affiliation(s)
- Logan Smith
- Cerebral Vascular Disease Research Laboratories, University of Miami, Miami, Florida.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | - Diya Chakraborty
- Cerebral Vascular Disease Research Laboratories, University of Miami, Miami, Florida.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | - Pallab Bhattacharya
- National Institute of Pharmaceutical Education and Research, Ahmedabad, Gujarat, India.,Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Deepaneeta Sarmah
- National Institute of Pharmaceutical Education and Research, Ahmedabad, Gujarat, India
| | - Sebastian Koch
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida
| | - Kunjan R Dave
- Cerebral Vascular Disease Research Laboratories, University of Miami, Miami, Florida.,Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida.,Neuroscience Program, University of Miami Miller School of Medicine, Miami, Florida
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12
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Mikhailidis DP, Barradas MA, Dandona P. Cardiovascular risk in patients with treated familial hypercholesterolaemia and patients with severe hypertriglyceridaemia. J R Soc Med 2018; 80:61. [PMID: 3560134 PMCID: PMC1290647 DOI: 10.1177/014107688708000127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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13
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Yeh CC, Venault A, Yeh LC, Chinnathambi A, Alharbi SA, Higuchi A, Chang Y. Universal Bioinert Control of Polystyrene Interfaces via Hydrophobic-Driven Self-Assembled Surface PEGylation with a Well-Defined Block Sequence. MACROMOL CHEM PHYS 2017. [DOI: 10.1002/macp.201700102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Chih-Chen Yeh
- Department of Chemical Engineering and R&D Center for Membrane Technology; Chung Yuan Christian University; 200 Chung Pei Road Chung-Li City 32023 Taiwan
| | - Antoine Venault
- Department of Chemical Engineering and R&D Center for Membrane Technology; Chung Yuan Christian University; 200 Chung Pei Road Chung-Li City 32023 Taiwan
| | - Lu-Chen Yeh
- Department of Chemical Engineering and R&D Center for Membrane Technology; Chung Yuan Christian University; 200 Chung Pei Road Chung-Li City 32023 Taiwan
| | - Arunachalam Chinnathambi
- Department of Botany and Microbiology; College of Science; King Saud University; P. O. Box 2455 Riyadh 11451 Saudi Arabia
| | - Sulaiman Ali Alharbi
- Department of Botany and Microbiology; College of Science; King Saud University; P. O. Box 2455 Riyadh 11451 Saudi Arabia
| | - Akon Higuchi
- Department of Chemical and Materials Engineering; National Central University; Jhong-Li Taoyuan 320 Taiwan
| | - Yung Chang
- Department of Chemical Engineering and R&D Center for Membrane Technology; Chung Yuan Christian University; 200 Chung Pei Road Chung-Li City 32023 Taiwan
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14
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Tsiara S, Elisaf M, Jagroop IA, Mikhailidis DP. Platelets as Predictors of Vascular Risk: Is There a Practical Index of Platelet Activity? Clin Appl Thromb Hemost 2016; 9:177-90. [PMID: 14507105 DOI: 10.1177/107602960300900301] [Citation(s) in RCA: 217] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Activated platelets play a role in the pathogenesis of coronary heart disease (CHD). Following activation, platelets change shape, aggregate, and release several bioactive substances. The aim of this review is to identify if there is a simple and cost-effective method that indicates platelet activation and predicts the risk of CHD and vascular events. The rationale for identifying high-risk patients is to reduce their risk of vascular events by administering appropriate and effective antiplatelet treatment, like aspirin, clopidogrel, or combination regimens. Many laboratory tests estimating platelet activity have been described. Some are relatively simple, such as spontaneous or agonist-induced platelet aggregation. Other tests include measuring the mean platelet volume (MPV) or plasma soluble P-selectin levels. Some more complex tests include flow cytometry to determine platelet GP Ilb/Illa receptors, platelet surface P-selectin, plateletmonocyte aggregates, and microparticles. Only few prospective studies assessed the predictive value of platelet activation in healthy individuals. Although the MPV seems an 'easy method, there are insufficient data supporting its ability to predict the risk of a vascular event in healthy adults. Platelet aggregation, in whole blood or in platelet-rich plasma was not consistently predictive of vascular risk. Soluble P-selectin measurement is a promising method but it needs further evaluation. Flow cytometry methods are costly, time-consuming, and need specialized equipment. Thus, they are unlikely to be useful in estimating the risk in large numbers of patients. There is as yet no ideal test for the detection of platelet activation. Each currently available test has merits and disadvantages. Simple methods such as the MPV and the determination of platelet release products need further evaluation.
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Affiliation(s)
- Stavroula Tsiara
- Department Clinical Biochemistry, Royal Free University College School of Medicine, University of London, Royal Free Campus, London NW3 2QG, UK
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15
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Ganotakis ES, Gazi IF, Papadakis JA, Jagroop IA, Nair DR, Mikhailidis DP. The Relationship Between Circulating Fibrinogen and Lipoprotein (a) Levels in Patients With Primary Dyslipidemia. Clin Appl Thromb Hemost 2016; 13:35-42. [PMID: 17164494 DOI: 10.1177/1076029606296256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The correlation between 2 predictors of vascular events, plasma fibrinogen and serum lipoprotein (a), was evaluated in patients referred to a specialist clinic because of primary hyperlipidemia. A significant correlation existed between fibrinogen and lipoprotein (a) in nonsmokers but not in smokers. Plasma fibrinogen concentration correlated positively and significantly with serum lipoprotein (a) levels in men nonsmokers without cardiovascular disease and in women nonsmokers with cardiovascular disease. Nonsmoker women without cardiovascular disease had significantly higher plasma fibrinogen (3.63 g/L versus 3.07 g/L, P < .0001) than the corresponding men. Nonsmoker women with and without cardiovascular disease had significantly higher lipoprotein (a) levels than the corresponding groups of men (0.36 versus 0.18 g/L; P = .0015 and 0.40 versus 0.26 g/L; P = .008), respectively. The relationship between fibrinogen and lipoprotein (a) levels alters markedly depending on the population selected. This relationship is influenced by gender, the presence of cardiovascular disease and smoking status.
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Affiliation(s)
- Emmanuel S Ganotakis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital Hampstead NHS Trust and Royal Free and University College Medical School, London, United Kingdom
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16
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The relationship between fibrinogen to albumin ratio and severity of coronary artery disease in patients with STEMI. Am J Emerg Med 2016; 34:1037-42. [PMID: 27017405 DOI: 10.1016/j.ajem.2016.03.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 02/23/2016] [Accepted: 03/01/2016] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin levels are of a higher specificity and sensitivity in ST-elevation myocardial infarction (STEMI). In this study, we sought to evaluate the association between fibrinogen to albumin ratio (FAR) and the extent and severity of CAD evaluated by TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries (SYNTAX) Score (SS) in patients with STEMI. METHODS A total of 278 patients with STEMI were included in the study. FAR was calculated using specified variables. The extent and severity of CAD were evaluated using the SS. The patients were divided into low- (SS <22) and high- (SS ≥22) risk groups. A Spearman rank correlation coefficient analysis was used for the relationship between FAR and SS. The cutoff points for sensitivity and specificity of FAR in predicting SS were estimated by performing a receiver operator characteristic curve analysis. RESULTS There were significant differences in the mean age (P=.016), admission serum albumin (P=.041), serum fibrinogen (P<.001), FAR (P<.001), and SS risk groups. Positive correlation was detected between FAR and SS (r=0.458, P<.001). A cutoff level of >87 FAR predicted SS (sensitivity, 70%; specificity, 70%), and an area under the curve of 0.758 serum fibrinogen and albumin level was an independent predictor for SS in patients with STEMI (b=0.039; 95% confidence interval, 0.016-0.062; P=.001 and b=-6.906; 95% confidence interval, -12.284 to -1.527; P=.013, respectively). CONCLUSION In the present study, we showed that FAR is significantly related to SS in predicting the severity of CAD in patients with STEMI.
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17
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Papazafiropoulou A, Papanas N, Pappas S, Maltezos E, Mikhailidis DP. Effects of oral hypoglycemic agents on platelet function. J Diabetes Complications 2015; 29:846-51. [PMID: 26026848 DOI: 10.1016/j.jdiacomp.2015.04.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 04/09/2015] [Accepted: 04/10/2015] [Indexed: 12/15/2022]
Abstract
Platelet dysfunction plays a role in diabetic macrovascular complications. Several studies have assessed the effect of oral hypoglycemic agents (OHAs) on platelet function. Data from both in vivo and in vitro studies show a favorable effect for most of the traditional glucose-lowering therapies, while evidence is limited for the newer ones. Metformin, sulfonylureas, glitazones and acarbose exert a favorable effect on platelet function. Among incretin therapies, only sitagliptin has so far been demonstrated to have a beneficial effect on platelet aggregation. More in vivo and in vitro evidence is required to increase our knowledge on any potential beneficial effects of OHAs on platelet function. Any such effect may have implications for the reduction of cardiovascular risk in type 2 diabetes mellitus.
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Affiliation(s)
- Athanasia Papazafiropoulou
- Diabetes Centre, Third Department of Internal Medicine, General Hospital of Nikaia, Piraeus, Greece; Diabetes Centre, First Department of Internal Medicine, Tzaneio General Hospital of Piraeus, Piraeus, Greece.
| | - Nikolaos Papanas
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stavros Pappas
- Diabetes Centre, Third Department of Internal Medicine, General Hospital of Nikaia, Piraeus, Greece
| | - Efstratios Maltezos
- Outpatient Clinic of Obesity, Diabetes and Metabolism, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitri P Mikhailidis
- Department of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free Hospital campus, University College London Medical School, London, UK
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18
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Malatino L, Cardella AM, Puccia G, Cilia C, Terranova V, Cataudella E, Buonacera A, Tripepi G, Di Marca S, Mastrosimone G, Pisano M, Giordano M, Stancanelli B. Testing Clinical Scores to Diagnose Incident Deep Vein Thrombosis in Patients Hospitalized in a Department of Medicine: Can Biomarkers Improve Accuracy? Angiology 2015; 67:245-51. [PMID: 25991607 DOI: 10.1177/0003319715586289] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Shifting the context from the emergency department to the department of medicine, we compared different scores to diagnose deep vein thrombosis (DVT) in patients with several comorbidities, hospitalized in a department of internal medicine. We prospectively recruited 178 consecutive hospitalized patients in whom clinical suspicion of DVT was assessed by Wells modified score for DVT, Hamilton, Kahn, and St Andrè Hospital scores. Deep vein thrombosis was confirmed in 85 (48%) patients by both echocolor Doppler and angiocomputed tomography scan. The use of risk scores based on symptoms and clinical signs was weakly useful (area under the curve [AUC]: 0.69, positive predictive value: 59%, and negative predictive value: 74%). Patients with DVT had significantly (P < .0001) lower serum albumin and protein S levels compared to those without DVT. Moreover, serum protein S (AUC: 0.82) and albumin in percentage (AUC: 0.80) showed a better accuracy than clinical scores (P < .001) in assessing the diagnosis of DVT. Therefore, serum albumin and protein S improved the accuracy of clinical scores for the diagnosis of incident DVT in patients hospitalized in a department of medicine.
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Affiliation(s)
- Lorenzo Malatino
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Antonella M Cardella
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Giuseppe Puccia
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Chiara Cilia
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Valentina Terranova
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Emanuela Cataudella
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Agata Buonacera
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | | | - Salvatore Di Marca
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Gianluca Mastrosimone
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Marcella Pisano
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
| | - Mauro Giordano
- Department of Medical, Surgical, Neurologic, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy
| | - Benedetta Stancanelli
- Department of Clinical and Experimental Medicine, Unit of Internal Medicine, c/o Ospedale Cannizzaro, Catania, Italy
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19
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Wu Q, Ding D, Liu X, Guo SW. Evidence for a Hypercoagulable State in Women With Ovarian Endometriomas. Reprod Sci 2015; 22:1107-14. [DOI: 10.1177/1933719115572478] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Qinjiao Wu
- Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xishi Liu
- Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
| | - Sun-Wei Guo
- Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, Shanghai, China
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20
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Kurtul A, Ocek AH, Murat SN, Yarlioglues M, Demircelik MB, Duran M, Ergun G, Cay S. Serum albumin levels on admission are associated with angiographic no-reflow after primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Angiology 2014; 66:278-85. [PMID: 24650948 DOI: 10.1177/0003319714526035] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low serum albumin (SA) levels are associated with increased cardiovascular mortality. We investigated whether baseline SA levels are associated with no-reflow following primary percutaneous coronary intervention (pPCI). A total of 536 patients (aged 60 ± 13 years; 74% men) who underwent pPCI were enrolled. The patients were divided into 2 groups: no-reflow and normal-reflow. No-reflow was defined as thrombolysis in myocardial infarction ≤2 flow. Admission SA levels were significantly lower in the no-reflow group than in the normal-reflow group (3.55 ± 0.44 vs 4.01 ± 0.32 mg/dL, P < .001). Also, high-sensitivity C-reactive protein (hsCRP), creatinine, creatine kinase myocardial band isoenzyme, and troponin T were significantly higher while hemoglobin and left ventricular ejection fraction (LVEF) were significantly lower in the no-reflow group. In multivariate analysis, SA level remained an independent predictor of angiographic no-reflow (odds ratio 0.114, 95% confidence interval 0.032-0.405, P = .001) together with LVEF, hsCRP, and baseline culprit artery patency. Admission SA level was an independent predictor of no-reflow after pPCI.
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Affiliation(s)
- Alparslan Kurtul
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Adil Hakan Ocek
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Sani Namik Murat
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Mikail Yarlioglues
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | | | - Mustafa Duran
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Gokhan Ergun
- Department of Cardiology, Ankara Education and Research Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
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21
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Affiliation(s)
- Elias E Mazokopakis
- 1Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece
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22
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Alcohol consumption and the heart. Int J Cardiol 2013; 168:4319. [DOI: 10.1016/j.ijcard.2013.04.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 04/20/2013] [Indexed: 11/18/2022]
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23
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Karagiannis A, Tziomalos K, Mikhailidis DP, Semertzidis P, Kountana E, Kakafika AI, Pagourelias ED, Athyros VG. Seasonal variation in the occurrence of stroke in Northern Greece: a 10 year study in 8204 patients. Neurol Res 2013; 32:326-31. [DOI: 10.1179/174313208x331608] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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24
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Mikhailidis DP, Ganotakis ES. Plasma albumin and platelet function: relevance to atherogenesis and thrombosis. Platelets 2012; 7:125-37. [PMID: 21043591 DOI: 10.3109/09537109609023571] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two papers published in this journal(1,2) during the past year remind us that plasma albumin concentrations can influence platelet function. These publications, together with epidemiological evidence showing that low plasma concentrations of albumin predict mortality from cardiovascular disease(3,4) have prompted this review.
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Affiliation(s)
- D P Mikhailidis
- Department of Chemical Pathology & Human Metabolism, Royal Free Hospital & School of Medicine (University of London), Pond Street, London NW3 2QG, UK
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25
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Heparin and platelet activation. Thromb Res 2012; 130:685; author reply 686. [PMID: 22819263 DOI: 10.1016/j.thromres.2012.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 06/21/2012] [Accepted: 06/29/2012] [Indexed: 11/23/2022]
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Capra V, Bäck M, Barbieri SS, Camera M, Tremoli E, Rovati GE. Eicosanoids and Their Drugs in Cardiovascular Diseases: Focus on Atherosclerosis and Stroke. Med Res Rev 2012; 33:364-438. [DOI: 10.1002/med.21251] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Valérie Capra
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
| | - Magnus Bäck
- Department of Cardiology and Center for Molecular Medicine; Karolinska University Hospital; Stockholm Sweden
| | | | - Marina Camera
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
- Centro Cardiologico Monzino; I.R.C.C.S Milan Italy
| | - Elena Tremoli
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
- Centro Cardiologico Monzino; I.R.C.C.S Milan Italy
| | - G. Enrico Rovati
- Department of Pharmacological Sciences; University of Milan; Via Balzaretti 9 20133 Milan Italy
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27
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Stevic I, Chan HH, Chan AK. Carotid artery dissections: Thrombosis of the false lumen. Thromb Res 2011; 128:317-24. [DOI: 10.1016/j.thromres.2011.06.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 06/16/2011] [Accepted: 06/24/2011] [Indexed: 11/30/2022]
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El Barbary MA, Saad AEM, Attia FM, Mandour MI, Haidara MA, Dallak MM, Isenovic ER. Thrombocytopenia in Patients With Chronic Hepatitis C: A Possible Role of HCV on Platelet Progenitor Cell Maturation. Angiology 2009; 61:304-13. [PMID: 19689996 DOI: 10.1177/0003319709343178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A total of 30 patients with chronic hepatitis C (HCV) thrombocytopenia (TP) and 20 healthy controls were studied. Both groups were subjected to complete medical history, clinical examination in addition to assessment of hepatitis markers: level of thrombopoietin (Tpo), Geimsa-stained bone marrow smears, and in vitro short-term megakaryocytic progenitors culture (CFU-MK). Serum Tpo level was significantly elevated in patients with TP HCV. Short-term CFU-MK showed an evident depression in the colony-forming unit—megakaryocyte (CFU-meg). There is a positive correlation between the number of CFU-meg and the platelet count and between serum Tpo level and prothrombin time, transaminase, albumin, and the Child Pugh score of liver disease; a negative correlation between serum Tpo level and the number of CFU-meg and between serum Tpo level and the platelet count. Thus, the level of Tpo could be an indicator of intact functional response of the hepatocytes.
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Affiliation(s)
- Magdy A. El Barbary
- Department of Physiology, Clinical pathology, College of Medicine, Suez Canal University, Ismailia, Egypt
| | - Alaa Eldin M. Saad
- Department of Physiology, Clinical pathology, College of Medicine, Suez Canal University, Ismailia, Egypt
| | - Fadia M. Attia
- Department of Physiology, Clinical pathology, College of Medicine, Suez Canal University, Ismailia, Egypt
| | - Magda I. Mandour
- Department of Physiology, Clinical pathology, College of Medicine, Suez Canal University, Ismailia, Egypt
| | - Mohamed A. Haidara
- Department of Physiology, Kasr-Al-Aini Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohammad M. Dallak
- Department of Physiology, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Esma R. Isenovic
- Vinča Institute, University of Belgrade, Department for Molecular Genetics and Radiobiology, Belgrade, Serbia
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29
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Mikhailidis DP, Barradas MA, Jeremy JY. Platelet Hyperactivity: A Predictor of Cardiac Events and Death from Myocardial Infarction. Platelets 2009; 1:217-8. [DOI: 10.3109/09537109009005492] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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30
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Al-Mugeiren MM, Gader AMA, Al-Rasheed SA, Bahakim HM, Al-Momen AK, Al-Salloum A. Platelet Aggregometry - Dose-related Responses to Arachidonic Acid in Childhood Nephrotic Syndrome. Platelets 2009; 6:71-4. [DOI: 10.3109/09537109509078446] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Mikhailidis DP, Barradas MA, O'donoghue S, Dandona P. Evidence for in vivo Platelet Activation Following the Injection of Conventional Unfractionated Heparin. Platelets 2009; 1:189-92. [DOI: 10.3109/09537109009005487] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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32
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Jagroop IA, Mikhailidis DP. The effect of tirofiban on fibrinogen/agonist-induced platelet shape change and aggregation. Clin Appl Thromb Hemost 2008; 14:295-302. [PMID: 18445610 DOI: 10.1177/1076029608316014] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
There is evidence linking raised plasma fibrinogen (fib) and platelet hyperactivity with vascular events. One way to inhibit platelets is to block the platelet membrane glycoprotein (GP) IIb/IIIa receptor, which binds circulating fib or von Willebrand factor and cross-links platelets at the final common pathway to platelet aggregation. Tirofiban is a potent and specific fib receptor antagonist, used in the treatment of unstable angina. The authors assessed the effect of tirofiban on spontaneous platelet aggregation (SPA), fib-induced, serotonin (5HT)-induced, and adenosine diphosphate (ADP)-induced aggregation in whole blood by calculating the percentage free platelet count. These various agonists were used alone and in combination. The authors also measured the effect of tirofiban on agonists-induced (ADP, 5HT) platelet shape change (PSC). The effect of fib on PSC was also evaluated in platelet-rich plasma using a high-resolution (0.07 fL) channelyzer. Tirofiban significantly inhibited SPA, fib (2, 4, 8 g/L), ADP, ADP + fib combination, and 5HT-induced aggregation. Tirofiban had no effect on agonist-induced PSC. There was no apparent change in platelet volume with fib. In conclusion, tirofiban does not appear to have an effect on PSC, an early phase of platelet activation. Tirofiban seems to be a nonspecific and an effective inhibitor of platelet aggregation (a later phase of platelet activation) in whole blood. The clinical significance of these findings remains to be established.
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Affiliation(s)
- I Anita Jagroop
- Department of Clinical Biochemistry, Royal Free University College School of Medicine, University College London, University of London, Royal Free Hospital Campus, London, UK
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33
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Abstract
AbstractDiet plays an important role in the primary and secondary prevention of cardiovascular disease. The growing perception that abnormal haemostatic processes of coagulation, platelet aggregation and fibrinolysis contribute to cardiovascular disease aetiology motivated this review on the relationships of diet, specific foods and nutrients with haemostatic function. Functional endpoints that reflect the function and status of some of these processes and which can be measured in dietary trials are identified. The effects of energy intake and expenditure, alcohol, total fat and specific fatty acids, non-starch polysaccharides (dietary fibre), antioxidant nutrients and some foods on a variety of haemostatic markers are reviewed. The results indicate that the prudent low-fat, high-fibre diet and maintenance of ideal body weight recommended to protect against and treat hyperlipidaemia and coronary heart disease will also benefit haemostatic profiles. It is concluded that more research on specific effects is needed for improved recommendations on a population level for prevention of cardiovascular disease.
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34
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Paraskevas KI, Baker DM, Vrentzos GE, Mikhailidis DP. The role of fibrinogen and fibrinolysis in peripheral arterial disease. Thromb Res 2007; 122:1-12. [PMID: 17669476 DOI: 10.1016/j.thromres.2007.06.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 06/11/2007] [Accepted: 06/15/2007] [Indexed: 10/23/2022]
Abstract
Peripheral arterial disease (PAD) is associated with high rates of cerebrovascular and cardiovascular events; PAD is a marker of systemic atherosclerosis. As a result, standard therapy for all PAD patients should be directed at both peripheral and systemic atherosclerosis. Modification of established risk factors in the form of smoking cessation, correcting hypertension, optimizing diabetic control and normalizing lipids is essential. Furthermore, novel risk factors have emerged including fibrinogen and other hemostatic factors. Fibrinogen is a coagulation factor and a marker of the acute phase response (inflammation), a platelet activator, a major determinant of plasma viscosity and a component of the atherosclerotic plaque. Fibrinogen appears not only to predict the severity of PAD, but also serves as a marker for future development of PAD. Whether reducing the levels of fibrinogen and other coagulation factors will decrease the incidence and progression of PAD remains to be resolved. This review summarizes the role of fibrinogen in the pathogenesis of PAD and its association with other hemostatic factors. The role of fibrinolysis in patients with PAD is also considered.
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Affiliation(s)
- Kosmas I Paraskevas
- Department of Clinical Biochemistry and Academic Department of Surgery, Royal Free Hospital, London, UK.
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35
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Jagroop IA, Mikhailidis DP. Heparin therapy leads to platelet activation and prolongation of platelet function analyser-100 closure time. J Cardiovasc Pharmacol Ther 2006; 11:156-7. [PMID: 16891295 DOI: 10.1177/1074248406289867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- I Anita Jagroop
- Department of Clinical Biochemistry and Department of Surgery, Royal Free and University College Medical School, University of London, Pond Street, London, United Kingdom
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36
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Deepa PR, Varalakshmi P. Favourable modulation of the inflammatory changes in hypercholesterolemic atherogenesis by a low-molecular-weight heparin derivative. Int J Cardiol 2006; 106:338-47. [PMID: 16337042 DOI: 10.1016/j.ijcard.2005.02.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2004] [Revised: 02/03/2005] [Accepted: 02/06/2005] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the hypercholesterolemic state, the net result of combined oxidative and nitrosative stress is a pro-inflammatory phenotype that is manifested as increased adhesion molecule expression, enhanced leucocyte trafficking, and increased vascular permeability. The present work explores the inflammatory aspects of hypercholesterolemic atherogenesis, and also evaluates the role of a low-molecular-weight heparin derivative (LMWH), Certoparin, on a biochemical basis. METHODS AND RESULTS Two groups of male Wistar rats were fed an atherogenic diet (normal rat chow plus 4% cholesterol, 1% cholic acid and 0.5% thiouracil-CCT diet) for 2 weeks. While one was left untreated, the other was administered LMWH (300 microg/day/rat commencing on day 8 and continued for a week). Increased concentrations of plasma C-reactive protein and fibrinogen and cardiac TNF-alpha indicated severe inflammation in the atherogenic diet fed rats. In comparison, these biochemical indices of inflammation diminished significantly in the LMWH treated group (p < 0.001). Significant depletion of thiols, along with accentuated activities of the glutathione metabolising was observed in the cardiac and hepatic tissues of the untreated atherogenic rats, indicating heightened oxidative response. Tissue damage was marked by elevated levels of plasma and tissue hexose, hexosamine, hexuronic acid and sialic acid, which were reversed towards normalcy on LMWH administration. The activities of lysosomal enzymes (N-acetyl glucosaminidase, beta-glucuronidase, beta-galactosaminidase and cathepsin-D) showed a marked increase in the CCT-diet fed rats, while LMWH treated rats showed normal activities (p < 0.001). The osmotic fragility test revealed that the untreated hyperlipidemic rat erythrocytes were significantly fragile at high salt concentrations, while the response was normalized in the LMWH treated group (p < 0.05). Further, hypercholesterolemia induced downregulation of physiological nitric oxide levels was corrected upon treatment with heparin-derivative. CONCLUSION The results of this work highlight the inflammatory changes in atherogenic conditions and that the low-molecular-weight heparin derivative affords substantial protection.
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Affiliation(s)
- P R Deepa
- Department of Medical Biochemistry, Dr. ALM Post Graduate Institute of Basic Medical Sciences, University of Madras, Taramani, Chennai 600 113, India.
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37
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Abstract
Beyond the already well-established strong causative relationship with cancer, smoking increases the risk for vascular disease. Smoking may act directly or adversely influence risk factors contributing to the development of vascular disease. Smoking causes endothelial dysfunction, dyslipidemia (decreased high-density lipoprotein cholesterol levels, hypertriglyceridemia and increased oxidation of low-density lipoprotein cholesterol) and platelet activation leading to a prothrombotic state. Smoking increases emerging risk factors (eg, fibrinogen, homocysteine, and high-sensitivity C-reactive protein) and increases insulin resistance and the risk of developing type 2 diabetes mellitus. The beneficial effects of statins and antioxidants (eg, vitamins C and E, beta-carotene) are counteracted by smoking. Smoking-induced alterations in growth factors, adhesion molecules, and even in genes can accelerate the progression of atherosclerosis. The aim of this review is to consider the adverse consequences of smoking on the factors predisposing to vascular disease and to emphasize the beneficial effects of smoking cessation.
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Affiliation(s)
- Stavroula Tsiara
- Internal Medicine Department, University of Ioannina Medical School, Ioannina, Greece
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38
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Jagroop IA, Malley M, Mikhailidis DP. Effect of clopidogrel on platelet aggregation and plasma concentration of fibrinogen in subjects with cerebral or coronary atherosclerotic disease. Clin Appl Thromb Hemost 2002; 8:381-2. [PMID: 12516689 DOI: 10.1177/107602960200800411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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39
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Matsagas MI, Geroulakos G, Mikhailidis DP. The role of platelets in peripheral arterial disease: therapeutic implications. Ann Vasc Surg 2002; 16:246-58. [PMID: 11972262 DOI: 10.1007/s10016-001-0159-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Peripheral arterial disease (PAD) is associated with platelet hyperaggregability as well as an increase in morbidity and mortality from myocardial infarction and stroke. Enhanced platelet activation in PAD may substantially contribute to these adverse outcomes. A relative resistance to aspirin therapy has been reported in patients with PAD. Therefore, clopidogrel may be superior to aspirin in treatment of PAD. Furthermore, the aspirin + clopidogrel combination could be more effective than monotherapy but its risk-benefit ratio has yet to be evaluated. Clopidogrel is preferable to ticlopidine because of its safer profile and the convenience of once-daily administration. The glycoprotein (Gp) IIb/IIIa inhibitors may also find a place as short-term therapy after peripheral angioplasty. There is a need to consider the use of clopidogrel in patients who cannot tolerate aspirin. Patients who have an event while taking aspirin also present a problem. One possibility here is to substitute aspirin with clopidogrel or to add clopidogrel to the aspirin. Although these options are currently not evidence based in patients with PAD, there is emerging evidence showing that they are realistic choices.
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Affiliation(s)
- M I Matsagas
- Department of Clinical Biochemistry, Royal Free and University College Medical School, University of London, London, UK
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40
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Mikhailidis D, Jagroop I. Regarding “Heparin modulates integrin function in human platelets”. J Vasc Surg 2002. [DOI: 10.1016/s0741-5214(02)70108-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Abstract
Strokes are one of the most common causes of mortality and long term severe disability. There is evidence that lipoprotein (a) (Lp(a)) is a predictor of many forms of vascular disease, including premature coronary artery disease. Several studies have also evaluated the association between Lp(a) and ischaemic (thrombotic) stroke. Several cross sectional (and a few prospective) studies provide contradictory findings regarding Lp(a) as a predictor of ischaemic stroke. Several factors might contribute to the existing confusion--for example, small sample sizes, different ethnic groups, the influence of oestrogens in women participating in the studies, plasma storage before Lp(a) determination, statistical errors, and selection bias. This review focuses on the Lp(a) related mechanisms that might contribute to the pathogenesis of ischaemic stroke. The association between Lp(a) and other cardiovascular risk factors is discussed. Therapeutic interventions that can lower the circulating concentrations of Lp(a) and thus possibly reduce the risk of stroke are also considered.
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Affiliation(s)
- H J Milionis
- Department of Molecular Pathology and Clinical Biochemistry, Royal Free and University College Medical School, University College, London, UK
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42
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Mehta D, Jeremy JY, Bashar Izzat M, Bryan AJ, Angelini GD. Towards a solution for saphenous vein graft failure. ACTA ACUST UNITED AC 1997. [DOI: 10.1016/s1328-0163(97)90004-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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43
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Malle E, Kostner GM. Effects of fish oils on lipid variables and platelet function indices. Prostaglandins Leukot Essent Fatty Acids 1993; 49:645-63. [PMID: 8248270 DOI: 10.1016/0952-3278(93)90074-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- E Malle
- Karl-Franzens University, Institute of Medical Biochemistry, Graz, Austria
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44
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45
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Barradas M, Christofides J, Jeremy J, Mikhailidis D, Fry D, Dandona P. The effect of olive oil supplementation on human platelet function, serum cholesterol-related variables and plasma fibrinogen concentrations: A pilot study. Nutr Res 1990. [DOI: 10.1016/s0271-5317(05)80667-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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46
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Mikhailidis DP, Barradas MA, Jeremy JY. The effect of ethanol on platelet function and vascular prostanoids. Alcohol 1990; 7:171-80. [PMID: 2109617 DOI: 10.1016/0741-8329(90)90080-v] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The present review will discuss the effects of ethanol on platelet function and vascular prostanoids. Whenever possible we have considered human studies because there are marked species differences in platelet function and vascular prostanoid release even in the absence of ethanol. Because of the specialised nature of some parts of the text, we have included brief introductions to help readers who are not familiar with this field.
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Affiliation(s)
- D P Mikhailidis
- Department of Chemical Pathology and Human Metabolism, Royal Free Hospital and School of Medicine, University of London, UK
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47
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Jeremy JY, Mikhailidis DP. Vascular and platelet eicosanoids, smoking and atherosclerosis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 1990; 273:135-46. [PMID: 2288270 DOI: 10.1007/978-1-4684-5829-9_14] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- J Y Jeremy
- Department of Chemical Pathology and Human Metabolism, Royal Free Hospital and School of Medicine, University of London, UK
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48
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Whitworth NH, Barradas MA, Mikhailidis DP, Dandona P. An investigation into the effects of bacterial lipopolysaccharide on human platelets. Eur J Haematol 1989; 43:112-9. [PMID: 2792318 DOI: 10.1111/j.1600-0609.1989.tb00266.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The addition of lipopolysaccharide (LPS) from Gram-negative bacteria to whole blood induced a consistent enhancement of platelet impedance aggregation (WB-PIA) and an increase in median platelet volume (MPV). In contrast, the addition of LPS to platelet rich plasma (PRP) resulted in inconsistent changes in turbidometric platelet aggregation (TPA) and no significant change in MPV. The LPS-induced increase of MPV in whole blood was inhibited by verapamil, a calcium channel blocker. We conclude that: (a) LPS consistently activates platelets in whole blood but not in PRP; (b) LPS-induced activation of platelets is probably mediated by products released by leucocytes and/or erythrocytes; (c) the increase in MPV induced by LPS is probably dependent upon calcium influx; and (4) an increase in MPV may be a useful and sensitive model for the study of platelet activation by LPS, in vitro and in vivo.
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Affiliation(s)
- N H Whitworth
- Department of Chemical Pathology and Human Metabolism, Royal Free Hospital, London, UK
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49
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Purdon AD, Rao AK. Interaction of albumin, arachidonic acid and prostanoids in platelets. Prostaglandins Leukot Essent Fatty Acids 1989; 35:213-8. [PMID: 2654961 DOI: 10.1016/0952-3278(89)90004-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- A D Purdon
- Thrombosis Research Center, Temple University School of Medicine, Philadelphia, PA 19140
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50
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Mikhailidis DP, Jeremy JY. Platelet function--the role of essential fatty acids and eicosanoids. Prostaglandins Leukot Essent Fatty Acids 1989; 35:187-8. [PMID: 2717655 DOI: 10.1016/0952-3278(89)90001-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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