Demographic diversity in platelet function and response to antiplatelet therapy

Longitudinal effects of Johnson & Johnson COVID-19 vaccination on metabolic biomarkers in type 2 diabetes mellitus in Ethiopia

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has disproportionately impacted individuals with type 2 diabetes mellitus (T2DM), increasing their risk of severe illness and mortality. Vaccination has been a crucial intervention in mitigating these risks. However, the metabolic effects of COVID-19 vaccination, particularly the Johnson & Johnson (J&J) vaccine, in diabetic populations remain inadequately explored. This study investigated the longitudinal effects of the J&J vaccine on lipid and eicosanoid biomarkers to assess its metabolic safety and potential cardiovascular benefits.

AIM

To evaluate the long-term impact of the J&J COVID-19 vaccine on lipid and eicosanoid biomarkers in Ethiopian patients with T2DM.

METHODS

This prospective cohort study was conducted at Adama Hospital Medical College (Oromia, Ethiopia) from May 2023 to June 2024. A total of 224 T2DM patients (57 vaccinated, 167 unvaccinated) were monitored for 1 year. Biomarkers including triglycerides (TGs), high-density lipoprotein (HDL), total cholesterol (TC), prostaglandins (PGs), and thromboxanes (TXs) were measured at baseline and at 3 months, 6 months, 9 months, and 1 year post-vaccination. Statistical analyses included Generalized Estimating Equations to assess longitudinal biomarker changes.

RESULTS

TG and PG levels remained stable across all time points. HDL levels showed a temporary decline at 3 months (mean difference [MD] = -4.33; P < 0.001) and 6 months (MD = -2.62; P < 0.001) but recovered by 9 months (MD = 2.09; P = 0.001) and 1 year (MD = 2.38; P < 0.001). TC exhibited a significant decrease at 3 months (MD = -16.44, P = 0.001) before stabilizing. TX levels showed a consistent decline across all follow-ups (e.g., 1 year: MD = -0.08; P = 0.036), suggesting a reduced thrombotic risk. Correlation analysis indicated significant interrelations among biomarkers, emphasizing their roles in metabolic and inflammatory pathways.

CONCLUSION

The J&J COVID-19 vaccine exhibited metabolic safety in patients with T2DM, with transient HDL and TC reductions that later stabilized and a sustained TX decline, suggesting potential cardiovascular benefits. Further studies are needed to explore long-term immunometabolic effects on high-risk populations.

Sex-specific predictive value of reticulated platelets in coronary artery disease: A systematic review and meta-analysis

BACKGROUND

Platelets play a crucial role in immune responses and haemostasis. Among them, reticulated platelets (RPs) have gathered attention for their association with prothrombotic states and as a potential biomarker for cardiovascular events. However, the sex-specific prognostic value of RPs remains underexplored.

OBJECTIVE

This study aimed to systematically review and analyse sex-specific differences in the prognostic role of RPs in cardiovascular disease.

METHODS

We conducted a comprehensive search on studies that reported patient outcomes related to RPs. Study authors were contacted to provide sex-specific patient-level data. Two studies were excluded due to data unavailability. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Secondary endpoints included cardiovascular death, myocardial infarction, stroke, urgent revascularization, and bleeding incidents. All outcomes were stratified by sex.

RESULTS

The analysis included 5 studies, reporting outcomes in 1835 patients (527 females and 1308 males). RPs are a significant predictor of MACCE independently of sex males (OR 1.99 [95% CI 1.3, 3.05; I2 = 29%]), females (2.29 [95% CI 1.31, 3.99; I2 = 10%]). For cardiovascular death RPs were predictive in females (OR 3.29 [95% CI 1.69, 6.40] I2 = .83%) and showed a trend toward significance in males (OR 2.19 95% CI [.98, 4.9] I2 = 42.72%). No sex-specific differences were observed in all other secondary endpoints.

CONCLUSION

RPs significantly predict MACCE in cardiovascular disease independently from sex and may have a stronger association with cardiovascular death in females. Further research is needed to explore the sex-specific mechanisms of RPs' prognostic value.