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Liu Y, Wu K, Xu R, He L, Zheng M, Wang J. Effect of mean platelet volume and platelet count on the prognosis of branch atheromatous disease. Brain Behav 2024; 14:e3509. [PMID: 38779748 PMCID: PMC11112397 DOI: 10.1002/brb3.3509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/26/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE The purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD). METHODS This retrospective study included 216 patients with BAD-stroke within 48 h of symptom onset. These patients were divided into good and poor prognosis groups according to their 3-month modified Rankin scale scores after discharge. Multiple logistic regression analysis was used to evaluate independent predictors of poor prognosis in BAD-stroke patients. Receiver-operating characteristic (ROC) analysis was used to estimate the predictive value of MPV and PC on BAD-stroke. RESULTS Our research showed that a higher MPV (aOR, 2.926; 95% CI, 2.040-4.196; p < .001) and PC (aOR, 1.013; 95% CI, 1.005-1.020; p = .001) were independently associated with poor prognosis after adjustment for confounders. The ROC analysis of MPV for predicting poor prognosis showed that the sensitivity and specificity were 74% and 84.9%, respectively, and that the AUC was .843 (95% CI, .776-.909, p < .001). The optimal cut-off value was 12.35. The incidence of early neurological deterioration (END) was 24.5% (53 of 163), and 66% of patients in the poor prognosis group had END (33 of 50). Multiple logistic regression analyses showed that elevated MPV and PC were associated with the occurrence of END (p < .05). CONCLUSION Our results suggested that an elevated MPV and PC may be important in predicting a worse outcome in BAD-stroke patients. Our study also demonstrated an independent association of MPV and PC with END, which is presumably the main reason for the poor prognosis.
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Affiliation(s)
- Yinglin Liu
- Department of NeurologyChengdu Second People's HospitalChengduSichuanChina
| | - Kun Wu
- Department of LaboratoryYibin Sixth People's HospitalChengduSichuanChina
| | - Ronghua Xu
- Department of NeurologyChengdu Second People's HospitalChengduSichuanChina
| | - Lanying He
- Department of NeurologyChengdu Second People's HospitalChengduSichuanChina
| | - Min Zheng
- Department of LaboratoryUniversity of Electronic Science and TechnologyChengduSichuanChina
| | - Jian Wang
- Department of NeurologyChengdu Second People's HospitalChengduSichuanChina
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Ludhiadch A, Yadav P, Singh SK, Sulena, Munshi A. Evaluation of mean platelet volume and platelet count in ischemic stroke and its subtypes: focus on degree of disability and thrombus formation. Int J Neurosci 2024; 134:503-510. [PMID: 36028984 DOI: 10.1080/00207454.2022.2118599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/14/2022] [Indexed: 10/15/2022]
Abstract
Background: Platelets are crucial players in thrombus formation during ischemic stroke. Platelet (PLT) count and Mean platelet volume (MPV) are important parameters that affect platelet functions. The current study has been carried out with an aim to evaluate the association of MPV and PLT count with ischemic stroke in a population from the Malwa region of Punjab. Material and Methods: The study included one hundred and fifty ischemic stroke patients. The extent of disability occurs by stroke was measured by mRS. MPV and PLT was evaluated using cell counter. Further, PLT count was confirmed in 50% of patients using flow cytometer. Clot formation rate was evaluated using Sonoclot Coagulation and Platelet Function Analyzer. All the statistical analysis was carried out using SPSS. Results: A significant association of increased MPV (p < 0.02) was found with the ischemic stroke. However, PLT count did not show a significant association with the disease (p < 0.07). Further, a stepwise multiple logistic regression (MLR) analysis controlling the other confounding risk factors evaluated the association of hypertension and MPV with the disease. Patients with higher mRS were found to have high MPV values confirming that higher MPV is correlated with disability occurs by ischemic stroke. MPV was also found to be significantly associated with large artery atherosclerosis (p < 0.001). Clot formation analysis revealed that ischemic stroke patients bear higher clot rate (CR) and Platelet function (PF) values. Conclusions: Elevated MPV is an independent risk factor for Ischemic stroke along with hypertension. In addition, higher MPV associated significantly with stroke disability as well.
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Affiliation(s)
- Abhilash Ludhiadch
- Complex Disease Genomics and Precision Medicine Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Pooja Yadav
- Department of Zoology, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Sunil Kumar Singh
- Department of Zoology, Central University of Punjab, Ghudda, Bathinda, Punjab, India
| | - Sulena
- Department of Neurology, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India
| | - Anjana Munshi
- Complex Disease Genomics and Precision Medicine Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Ghudda, Bathinda, Punjab, India
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Catană A, Andrei CL, Guberna S, Ceban O, Sinescu CJ. Possible Correlations between Mean Platelet Volume and Biological, Electrocardiographic, and Echocardiographic Parameters in Patients with Heart Failure. Life (Basel) 2024; 14:260. [PMID: 38398768 PMCID: PMC10890115 DOI: 10.3390/life14020260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/07/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Despite advancements in medical research and discoveries, heart failure (HF) still represents a significant and prevalent public health challenge. It is characterized by persistently high mortality and morbidity rates, along with increased rates of readmissions, particularly among the elderly population. (2) Methods: This study was conducted retrospectively on 260 patients with stable or decompensated chronic HF. The parameter of interest in the study population was the mean platelet volume (MPV), and the main objective of the research was to identify a possible relationship between MPV and several variables-biological (NT-proBNP, presepsin, red cell distribution width (RDW)), electrocardiographic (atrial fibrillation (AFib) rhythm, sinus rhythm (SR)), and echocardiographic (left ventricle ejection fraction (LVEF), left atrial (LA) diameter, left ventricle (LV) diameter, pulmonary hypertension (PH)). (3) Results: By applying logistic and linear regression models, we assessed whether there is a correlation between MPV and biological, electrocardiographic, and echocardiographic variables in patients with HF. The results revealed linear relationships between MPV and NT pro-BNP values and between MPV and RDW values, and an increased probability for the patients to have an AFib rhythm, reduced LVEF, dilated LA, dilated LV, and PH as their MPV value increases. The results were deemed statistically relevant based on a p-value below 0.05. (4) Conclusions: Through regression model analyses, our research revealed that certain negative variables in HF patients such as increased levels of NT-proBNP, increased levels of RDW, AFib rhythm, reduced LVEF, dilated LA, dilated LV, and PH, could be predicted based on MPV values.
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Affiliation(s)
- Andreea Catană
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 020021 Bucharest, Romania; (S.G.); (C.J.S.)
| | - Cătălina Liliana Andrei
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 020021 Bucharest, Romania; (S.G.); (C.J.S.)
| | - Suzana Guberna
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 020021 Bucharest, Romania; (S.G.); (C.J.S.)
| | - Octavian Ceban
- Economic Cybernetics and Informatics Department, The Bucharest University of Economic Studies, 010552 Bucharest, Romania;
| | - Crina Julieta Sinescu
- Department of Cardiology, University of Medicine and Pharmacy “Carol Davila”, Emergency Hospital “Bagdasar-Arseni”, 020021 Bucharest, Romania; (S.G.); (C.J.S.)
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Ince O, Gulsen K, Ozcan S, Donmez E, Ziyrek M, Sahin I, Okuyan E. Is dynamic change in mean platelet volume related with composite endpoint development after transcatheter aortic valve replacement? Blood Coagul Fibrinolysis 2023; 34:487-493. [PMID: 37756207 DOI: 10.1097/mbc.0000000000001255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Aortic valve stenosis (AS) is the most common valvular disease, and surgical or transcatheter aortic valve replacement (TAVR) are the treatment options. Diminish in platelet production or dysfunction may occur due to shear stress, advanced age, and other coexisting diseases in AS patients. Bleeding is one of the complications of TAVR and associated with increased mortality. MPV (mean platelet volume) indicates platelet's thrombogenic activity. Overproduction or consumption of platelets in various cardiac conditions may affect MPV values. We aimed to investigate the pre and postprocedure MPV percentage change (MPV-PC) and its association with post-TAVR short-term complications. A total of 204 patients who underwent TAVR with a diagnosis of severe symptomatic AS were included. The mean age was 78.66 ± 6.45 years, and 49.5% of patients were women. Two groups generated according to composite end point (CEP) development: CEP(+) and CEP(-).110 patients(53.9%) formed CEP(+) group. Although baseline MPV and platelet levels were similar between groups, MPV was increased ( P < 0.001) and platelet was decreased ( P < 0.001) significantly following the procedure when compared to baseline. MPV-PC was significantly higher in the VARC type 2-4 bleeding ( P = 0.036) and major vascular, access-related, or cardiac structural complication groups ( P = 0.048) when CEP subgroups were analyzed individually. Regression analysis revealed that diabetes mellitus [ P = 0.044, β: 1.806 odds ratio (95% confidence interval): 1.016-3.21] and MPV-PC [ P = 0.007,β: 1.044 odds ratio (95% confidence interval): 1.012-1.077] as independent predictors of CEP development at 1 month after TAVR. The MPV increase following TAVR may be an indicator of adverse outcomes following TAVR procedure within 1-month.
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Affiliation(s)
- Orhan Ince
- Department of Cardiology, Istanbul Bagcilar Training and Research Hospital
| | - Kamil Gulsen
- Department of Cardiology, Health and Science University Kartal Kosuyolu Training and Research Hospital, Istanbul
| | - Sevgi Ozcan
- Department of Cardiology, Istanbul Bagcilar Training and Research Hospital
| | - Esra Donmez
- Department of Cardiology, Istanbul Bagcilar Training and Research Hospital
| | - Murat Ziyrek
- Department of Cardiology, Konya Farabi Hospital, Konya, Turkey
| | - Irfan Sahin
- Department of Cardiology, Istanbul Bagcilar Training and Research Hospital
| | - Ertugrul Okuyan
- Department of Cardiology, Istanbul Bagcilar Training and Research Hospital
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Ludhiadch A, Sulena, Singh S, Chakraborty S, Sharma D, Kulharia M, Singh P, Munshi A. Genomic Variation Affecting MPV and PLT Count in Association with Development of Ischemic Stroke and Its Subtypes. Mol Neurobiol 2023; 60:6424-6440. [PMID: 37453995 DOI: 10.1007/s12035-023-03460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/22/2023] [Indexed: 07/18/2023]
Abstract
Platelets play a significant role in the pathophysiology of ischemic stroke since they are involved in the formation of intravascular thrombus after erosion or rupture of the atherosclerotic plaques. Platelet (PLT) count and mean platelet volume (MPV) are the two significant parameters that affect the functions of platelets. In the current study, MPV and PLT count was evaluated using flow cytometry and a cell counter. SonoClot analysis was carried out to evaluate activated clot timing (ACT), clot rate (CR), and platelet function (PF). Genotyping was carried out using GSA and Sanger sequencing, and expression analysis was performed using RT-PCR. In silico analysis was carried out using the GROMACS tool and UNAFold. The interaction of significant proteins with other proteins was predicted using the STRING database. Ninety-six genes were analyzed, and a significant association of THPO (rs6141) and ARHGEF3 (rs1354034) was observed with the disease and its subtypes. Altered genotypes were associated significantly with increased MPV, decreased PLT count, and CR. Expression analysis revealed a higher expression in patients bearing the variant genotypes of both genes. In silico analysis revealed that mutation in the THPO gene leads to the reduced compactness of protein structure. mRNA encoded by mutated ARHGEF3 gene increases the half-life of mRNA. The two significant proteins interact with many other proteins, especially the ones involved in platelet activation, aggregation, erythropoiesis, megakaryocyte maturation, and cytoskeleton rearrangements, suggesting that they could be important players in the determination of MPV values. In conclusion, the current study demonstrated the role of higher MPV affected by genetic variation in the development of IS and its subtypes. The results of the current study also indicate that higher MPV can be used as a biomarker for the disease and altered genotypes, and higher MPV can be targeted for better therapeutic outcomes.
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Affiliation(s)
- Abhilash Ludhiadch
- Complex Disease Genomics and Precision Medicine Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Ghudda, Bathinda, Punjab, 151401, India
| | - Sulena
- Department of Neurology, Guru Gobind Singh Medical College and Hospital, Sadiq Road, Faridkot, Punjab, 151203, India
| | | | - Sudip Chakraborty
- Department of Computational Sciences, School of Basic and Applied Sciences, Central University of Punjab, Ghudda, Bathinda, Punjab, 151401, India
| | - Dixit Sharma
- Department of Animal Sciences, School of Life Sciences, Central University of Himachal Pradesh, Kangra, Himachal Pradesh, 176206, India
| | - Mahesh Kulharia
- Centre for Computational Biology and Bioinformatics, School of Life Sciences, Central University of Himachal Pradesh, Kangra, Himachal Pradesh, 176206, India
| | - Paramdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bathinda, Punjab, 151001, India
| | - Anjana Munshi
- Complex Disease Genomics and Precision Medicine Laboratory, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Ghudda, Bathinda, Punjab, 151401, India.
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González-Sierra M, Romo-Cordero A, Quevedo-Abeledo JC, Quevedo-Rodríguez A, Gómez-Bernal F, de Vera-González A, López-Mejías R, Martín-González C, González-Gay MÁ, Ferraz-Amaro I. Mean Platelet Volume in a Series of 315 Patients with Rheumatoid Arthritis: Relationship with Disease Characteristics, including Subclinical Atherosclerosis and Cardiovascular Comorbidity. Diagnostics (Basel) 2023; 13:3208. [PMID: 37892031 PMCID: PMC10605652 DOI: 10.3390/diagnostics13203208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/09/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
Mean platelet volume (MPV) refers to the average platelet size in femtoliters. Increased or decreased MPV has been associated with several disorders, including inflammatory and cardiovascular diseases. In the present study, our objective was to analyze the relationship of MPV with disease activity in a large and well-characterized series of patients with rheumatoid arthritis (RA). This is a cross-sectional study that included 315 patients with RA and 208 controls matched by sex and age. Complete blood count, including MPV, was assessed. Multivariable analysis was performed to examine the relationship of MPV with RA disease characteristics, carotid atherosclerosis, and traditional cardiovascular factors, including a comprehensive profile of lipid molecules and insulin resistance or beta cell function indices. The multivariable analysis, which includes other hematological modifications produced by the disease and platelet values, showed that MPV levels were significantly lower in RA patients than in controls. Erythrocyte sedimentation rate and interleukin-6, but not C-reactive protein, were negatively correlated with MPV after adjustment for covariates. Similarly, disease activity and MPV had a significant and independent negative correlation. No relationships were found between MPV and cardiovascular risk factors, lipid profile or insulin resistance indices or subclinical atherosclerosis. In conclusion, patients with RA have lower levels of MPV than controls. MPV is negatively related to acute phase reactants and disease activity in RA.
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Affiliation(s)
- Marta González-Sierra
- Division of Hospitalization-at-Home, Hospital Universitario de Canarias, 38320 Tenerife, Spain;
| | - Alejandro Romo-Cordero
- Division of Internal Medicine, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (A.R.-C.); (C.M.-G.)
| | - Juan Carlos Quevedo-Abeledo
- Division of Rheumatology, Hospital Universitario Dr. Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.Q.-R.)
| | - Adrián Quevedo-Rodríguez
- Division of Rheumatology, Hospital Universitario Dr. Negrín, 35010 Las Palmas de Gran Canaria, Spain (A.Q.-R.)
| | - Fuensanta Gómez-Bernal
- Division of Central Laboratory, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (F.G.-B.); (A.d.V.-G.)
| | - Antonia de Vera-González
- Division of Central Laboratory, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (F.G.-B.); (A.d.V.-G.)
| | - Raquel López-Mejías
- Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), 39011 Santander, Spain;
| | - Candelaria Martín-González
- Division of Internal Medicine, Hospital Universitario de Canarias, 38320 Tenerife, Spain; (A.R.-C.); (C.M.-G.)
- Internal Medicine Department, Universidad de La Laguna, 38200 Tenerife, Spain
| | - Miguel Ángel González-Gay
- Department of Medicine and Psychiatry, Universidad de Cantabria, 39005 Santander, Spain
- Division of Rheumatology, IIS-Fundación Jiménez Díaz, 28040 Madrid, Spain
| | - Iván Ferraz-Amaro
- Internal Medicine Department, Universidad de La Laguna, 38200 Tenerife, Spain
- Division of Rheumatology, Hospital Universitario de Canarias, 38320 Tenerife, Spain
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Nejatifar F, Mirbolouk N, Masooleh IS, Kazemnejad E, Ghavidel-Parsa B, Ghanbari AM, Zayeni H. Association between neutrophil/lymphocyte ratio and disease severity in scleroderma patients. Heliyon 2023; 9:e20576. [PMID: 37860553 PMCID: PMC10582306 DOI: 10.1016/j.heliyon.2023.e20576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/21/2023] Open
Abstract
Introduction Systemic sclerosis is a chronic and progressive connective tissue disease with various manifestation. Inflammatory status is developed in early stages and is followed by major organs' dysfunction. Disease severity is evaluated mostly through Medsger scale. There is not any single laboratory test to evaluate disease severity, although some hematologic can reflect disease severity. In this study, we evaluated the association between hematologic indices (specially Neutrophil/Lymphocyte ratio) and Medsger score of disease severity. Materials and methods One hundred and twenty-three patients along with the same number of healthy controls were enrolled in this study. Demographic information and past medical records were gathered in first appointment. Hematologic indices were calculated based on the laboratory findings and the association between these indices and Medsger score of disease severity was evaluated. Results One hundred and twenty-three patients with mean disease duration of 9.54 and mean Medsger score of 7.42 were investigated in this study. Neutrophil count, erythrocyte sedimentation rate, red cell distribution width and NLR were significantly higher and mean platelets volume was significantly lower in SSc patients in comparison to controls. NLR was significantly correlated with pulmonary and cardiac involvements and Monocyte/Lymphocyte ratio was significantly correlated with the involvement of joint and tendons. We showed that NLR is a predictive factor for the severity of systemic sclerosis. We also found a cut off Value of 1.9 for NLR as a predictor for disease severity in our patients. Conclusion Our study shows that SSc and its severity is associated with some hematologic indices like NLR, MLR, platelets and hemoglobin. These indices can also specifically predict the involvement of some organs.
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Affiliation(s)
- Fatemeh Nejatifar
- Hematology and Medical Oncology Department, Guilan University of Medical Sciences, Rasht, Iran
| | - Neda Mirbolouk
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Irandokht Shenavar Masooleh
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad
- Guilan Trauma Research Center, Department of Biostatistics and Epidemiology, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Banafsheh Ghavidel-Parsa
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Mohammad Ghanbari
- Student Research Committee, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Habib Zayeni
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Chen C, Lv H, Shan L, Long X, Guo C, Huo Y, Lu L, Zhou Y, Liu M, Wu H, Zhu D, Han Y. Antiplatelet effect of ginkgo diterpene lactone meglumine injection in acute ischemic stroke: A randomized, double-blind, placebo-controlled clinical trial. Phytother Res 2023; 37:1986-1996. [PMID: 36609866 DOI: 10.1002/ptr.7720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/01/2022] [Accepted: 12/18/2022] [Indexed: 01/08/2023]
Abstract
This study was designed to evaluate antiplatelet effect and therapeutic effect of ginkgo diterpene lactone meglumine injection (GDLI) in acute ischemic stroke (AIS) patients. In this randomized, double-blind, placebo-controlled trial, we randomly assigned 70 inpatients within 48 hr after the onset of AIS to combination therapy with GDLI and aspirin (GDLI at a dose of 25 mg/d for 14 days plus aspirin at a dose of 100 mg/d for 90 days) or to placebo plus aspirin in a ratio of 1:1. Platelet function, the National Institute of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS) were evaluated. A good outcome was defined as NIHSS scores decrease ≥5 or mRS scores decrease ≥2. Results showed that arachidonic acid induced maximum platelet aggregation rate (AA-MAR) and mean platelet volume (MPV) of the GDLI-aspirin group were much lower than that of the aspirin group (p = 0.013 and p = 0.034, respectively) after the 14-day therapy. The combination of GDLI and aspirin was superior to aspirin alone, and had significant impact on the good outcome at day 90 (ORadj 7.21 [95%CI, 1.03-50.68], p = 0.047). In summary, GDLI has antiplatelet effect and can improve the prognosis of AIS patients.
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Affiliation(s)
- Chunxiang Chen
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Huihui Lv
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lili Shan
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xie Long
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Cen Guo
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yajing Huo
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingdan Lu
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yinting Zhou
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingyuan Liu
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Haibo Wu
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Desheng Zhu
- Department of Neurology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yan Han
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Tunca O, Kazan S, Kazan ED. Can mean platelet volume predicts renal outcome in acute on chronic kidney disease? Ther Apher Dial 2023; 27:232-239. [PMID: 36165352 DOI: 10.1111/1744-9987.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/13/2022] [Accepted: 09/24/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study aimed to investigate the role of mean platelet volume (MPV) in predicting renal outcome in acute kidney injury (AKI) developing on pre-existing chronic kidney disease (CKD). METHODS The patients whose first hemodialysis program was initiated in our center were divided into two groups as those who were taken to the scheduled dialysis program after discharge and those who were not dialysis-dependent. Groups were compared in terms of demographic characteristics, and laboratory parameters including MPV. RESULTS A total of 288 patients were included in the study (scheduled dialysis = 162 patients, nondialysis dependent = 126 patients). High MPV was found to be an independent risk factor for scheduled dialysis programs in multivariable analyses (OR [95% CI]: 90.9 [6.3-1313.6], p: 0.001). CONCLUSION CKD patients with high MPV were more likely to be included in scheduled dialysis programs after an AKI attack. MPV is found to be an independent risk factor and a reliable predictor for a scheduled dialysis program.
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Affiliation(s)
- Onur Tunca
- Department of Internal Medicine, Afyonkarahisar Health Science University, Faculty of Medicine, Division of Nephrology, Afyonkarahisar, Turkey
| | - Sinan Kazan
- Department of Internal Medicine, Afyonkarahisar Health Science University, Faculty of Medicine, Division of Nephrology, Afyonkarahisar, Turkey
| | - Elif Dizen Kazan
- Department of Internal Medicine, Afyonkarahisar Health Science University, Faculty of Medicine, Afyonkarahisar, Turkey
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Qiu F, Zhang H, He Y, Liu H, Zheng T, Xia W, Xu S, Zhou J, Li Y. Associations of arsenic exposure with blood pressure and platelet indices in pregnant women: A cross-sectional study in Wuhan, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114378. [PMID: 36525950 DOI: 10.1016/j.ecoenv.2022.114378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/14/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Environmental inorganic arsenic (iAs) exposure is potentially related to abnormal blood pressure (BP) changes and abnormal platelet activation. However, limited epidemiological studies have explored the impacts of iAs exposure on platelet change mediated by BP, especially for pregnant women. OBJECTIVES Our purpose was to investigate the associations of arsenic exposure with blood pressure and platelet indices among pregnant women. METHODS The present study population included 765 pregnant women drawn from a prospective birth cohort study in Wuhan, China, recruited between October 2013 and April 2016. Urine sampled in the second trimester were used to assess arsenic species concentrations. The relative distribution of urinary arsenic species was used to measure human methylation capacity. BP parameters and platelet indices originated from the medical record. We applied multivariable linear regression models to explore the cross-sectional relationships between urinary arsenic metabolites, BP parameters, and platelet indices. We utilized mediation analysis to investigate the impacts of arsenic exposure on platelet indices through BP as mediator variables. RESULTS We observed significant positive correlations between iAs and systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP). Pregnant women with higher methylation capacity to metabolize iAs characterized by higher secondary methylation index (SMI) and total methylation index (TMI) had a more significant reduction in SBP, DBP, and MAP. Pregnant women with higher DBP and MAP had higher platelet counts (PLC). A decreased PLC was found in subjects wither higher SMI. Additionally, SMI was negatively linked to PLC mediated through MAP. CONCLUSIONS Obtained results suggested that higher methylation capacity to metabolize iAs might contribute to decreased PLC among pregnant women, and MAP might mediate the influence of SMI on PLC.
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Affiliation(s)
- Feng Qiu
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | | | - Yujie He
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hongxiu Liu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI 02912, United States
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jieqiong Zhou
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Department of Gynaecology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yuanyuan Li
- Institute of Maternal and Child Health, Wuhan Children's Hospital, Tongji Medical College, Huazhong University and Technology, Wuhan 430016, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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11
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Liu X, Yu S, Liang T, Chen L, Zhang H. Mean Platelet Volume to Platelet Count Ratio Predicts Left Atrial Stasis in Patients with Non-Valvular Atrial Fibrillation. Int J Gen Med 2023; 16:847-858. [PMID: 36895511 PMCID: PMC9990455 DOI: 10.2147/ijgm.s395305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 02/23/2023] [Indexed: 03/06/2023] Open
Abstract
Background The mean platelet volume to platelet count ratio (MPV/PC) has been investigated in the diagnosis, prognosis and risk stratification in several diseases. However, the predictive role of MPV/PC in left atrial stasis (LAS) of non-valvular atrial fibrillation (NVAF) patients remains unknown. Methods A total of 217 consecutive NVAF patients undergoing transesophageal echocardiogram (TEE) evaluation were retrospectively enrolled. The demographic, clinical, admission laboratory and TEE data were extracted and analyzed. Patients were categorized into those with or without LAS. The associations between the MPV/PC ratio and LAS were assessed by multivariate logistic regression analysis. Results There were 24.9% (n = 54) patients with LAS according to TEE. Compared with patients without LAS, the MPV/PC ratio was significantly higher in those with LAS (5.6±1.6 vs 4.8±1.0, P < 0.001). After multivariable adjustment, higher MPV/PC ratio levels (OR 1.747, 95% CI 1.193-2.559, P = 0.004) were positively associated with LAS, with the optimal cut-point for LAS prediction of 5.36 (area under the curve, AUC = 0.683, sensitivity 48%, specificity 73%, 95% CI 0.589-0.777, P < 0.001). The stratification analysis showed that a significant positive correlation between MPV/PC ratio ≥5.36 and LAS in patients of male, younger (<65 years), paroxysmal AF, without history of stroke/TIA, CHA2DS2-VASc score ≥2, left atrial diameter (LAD) ≥40mm and left atrial volume index (LAVI) >34mL/m2 (all P < 0.05). Conclusion Increasing MPV/PC ratio was associated with an increased risk of LAS, which was mainly reflected in the subgroups of male, younger (<65 years), paroxysmal AF, without history of stroke/TIA, CHA2DS2-VASc score ≥2, LAD ≥40mm and LAVI >34mL/m2 patients.
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Affiliation(s)
- Xiaoyan Liu
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Shandong Yu
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Tuo Liang
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Lizhu Chen
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Heping Zhang
- Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
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Sadeghzadeh M, Khoshnevisasl P, Fallah R, Marzban A, Ghodrati D. The relationship between mean platelet volume (MPV) and intraventricular hemorrhage in very low birth weight infants. J Neonatal Perinatal Med 2023; 16:681-687. [PMID: 38043026 DOI: 10.3233/npm-230164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Intra ventricular hemorrhage (IVH) is a major cause of mortality among very low birth weight infants. This study aimed to investigate the relationship between mean platelet volume (MPV) and IVH in very low birth weight infants. METHOD In this cohort study, all premature infants weighing less than 1500 grams who were admitted to the NICU were enrolled from August 2018 to July 2019. Brain ultrasonography was performed on the first and seventh days and one month of age and were compared with Platelet count and MPV. RESULTS From 183 neonates, 23 cases (12.6%) had IVH. The mean MPV on the first day in the group with IVH was 10.48±0.85 and in the non-IVH group was 9.9±0.74 (P = 0.005). The mean MPV on the seventh day in the IVH and non-IVH group were 10.4±0.92 and 10.03±0.74 (P = 0.04) respectively. On the first and seventh day, for one unit of MPV increase, the chance of IVH increased by 2.68 and 2.1 respectively. (p = 0.001; OR3.643; 95% CI [1.703-7.753]). CONCLUSION The mean MPV index is significantly higher in the infants with IVH and therefore it can be used in early detection of IVH in neonates weighing less than 1500 grams.
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Affiliation(s)
- Mansour Sadeghzadeh
- Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Parisa Khoshnevisasl
- Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Ramezan Fallah
- Department of Epidemiology and Biostatistics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Asghar Marzban
- Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Davood Ghodrati
- Department of Pediatrics, Zanjan University of Medical Sciences, Zanjan, Iran
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Choi JW, Lee KO, Jang YJ, Kim HK, Seo T, Roh YJ, Choo SO, Oh SH. High Mean Platelet Volume Is Associated with Cerebral White Matter Hyperintensities in Non-Stroke Individuals. Yonsei Med J 2023; 64:35-41. [PMID: 36579377 PMCID: PMC9826963 DOI: 10.3349/ymj.2022.0368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/09/2022] [Accepted: 11/09/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The mean platelet volume (MPV) is regarded as a marker for thrombosis, atherosclerosis, and inflammation in various vascular diseases. However, it still remains unclear whether plasma MPV is associated with cerebral white matter hyperintensities (WMH) and cerebral microvascular pathology in the elderly population. MATERIALS AND METHODS We examined whether MPV level is associated with the presence of cerebral WMH on brain magnetic resonance imaging from 870 non-stroke outpatient subjects. The subjects were divided into three groups according to the consecutive level of MPV (low T1, middle T2, and high T3 MPV tertile groups). To determine the association of MPV levels with the WMH, logistic regression and receiver operating characteristic curve analyses were conducted. RESULTS Subjects with higher MPV level were older and more likely to have hypertension, diabetes mellitus, and low renal function. Cerebral WMH were more prevalent in subjects with higher MPV level. After adjusting for confounding factors, moderate to severe cerebral WMH were significantly associated with high MPV tertile level. This association remained significant after adjusting for other cerebral vascular pathologies. T2 [odds ratio (OR): 1.49, 95% confidence interval (CI): 1.03-2.15] and T3 MPV tertile groups (OR: 1.51, 95%CI: 1.04-2.20) had more cerebral WMH lesions compared to T1 MPV tertile group. In addition, the subjects with higher Fazekas scores showed higher MPV level (p=0.020). CONCLUSION We found that high MPV level is independently associated with cerebral WMH. This result suggests that platelet activation plays a role in the development of cerebral WMH.
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Affiliation(s)
- Jung-Won Choi
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
| | - Kee Ook Lee
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea.
| | - Ye-Ji Jang
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
| | - Hyun-Kyung Kim
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
| | - Taeho Seo
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
| | - Yoo Jeong Roh
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
| | - Seung-Ook Choo
- Department of Biomedical Laboratory Science, College of Natural Science Daejeon University, Daejeon, Korea
| | - Seung-Hun Oh
- Department of Neurology, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, Korea
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Terai P, Tongsong T, Jatavan P. Platelet function in newborns and the women affected by pregnancy-induced hypertension. J Matern Fetal Neonatal Med 2022; 35:10466-10471. [PMID: 36184257 DOI: 10.1080/14767058.2022.2128666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Platelet dysfunction is one of the serious and common complications associated with pregnancy-induced hypertension (PIH). Nevertheless, the role of platelet dysfunction in the newborns of PIH mothers is unclear. This study aimed to study platelet problems in infants and women affected by PIH. METHODS A prospective cohort study was conducted on singleton pregnancies who delivered at a gestation age of 32 weeks or more. The women were divided into the PIH group and the normal control group. The blood tests for maternal and neonatal platelet evaluation such as platelet concentration, mean platelet volume (MPV), and clotting time were performed for comparisons between both groups. RESULTS A total of 106 cases were recruited for the study (55 cases in the PIH group and 51 cases in the control group). Hematologic studies showed a significant increase in the incidence of thrombocytopenia and platelet dysfunction (increased MPV) in women affected with PIH when compared with those in the control group (p = .028 and p = .001). However, the platelet study in newborns was not significantly different between both groups (p = .680 and p = .265). CONCLUSIONS This study supports the theory that endothelial cell damage and platelet aggregation as indicated by thrombocytopenia together with increased MPV levels in maternal affected with PIH. Importantly, this study provides new insight into that these problems in mothers with PIH do not occur in their neonatal vessels, as indicated by normal platelet counts and MPV levels.
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Affiliation(s)
- Pinnapa Terai
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Theera Tongsong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phudit Jatavan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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15
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Brahmbhatt KJ, Chaudhary B, Raval DM, Mallik S, Khan S, Patel M, Patel N. Association of Mean Platelet Volume With Vascular Complications in the Patients With Type 2 Diabetes Mellitus. Cureus 2022; 14:e29316. [PMID: 36277526 PMCID: PMC9580037 DOI: 10.7759/cureus.29316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
Background Diabetes mellitus (DM) is a global health concern that is predicted to involve over 10% of the adult population by the next decade. Vascular complications are the major source of mortality and morbidity in diabetics. Mean platelet volume (MPV) which indicates platelet activity may play a crucial role in the vascular effects of DM and, hence, can be used as a prognostic marker. We have attempted to study the association of MPV with the glycemic status, duration of diabetes, and presence of vascular complications in diabetics. Methods A cross-sectional study of 300 patients with type 2 DM aged ≥18 years admitted to the inpatient department of medicine was carried out in a tertiary care hospital. After subgrouping patients according to their glycemic status and MPV, the association between microvascular and macrovascular complications was studied. Results The majority of patients were >60 years of age and an increasing prevalence of vascular complications was noted with increasing age. Forty-six percent and 45% of the patients had microvascular and macrovascular complications, respectively. Ischemic heart disease (IHD) and retinopathy were the most common macrovascular and microvascular complications, respectively. Vascular complications in DM showed a significant association with MPV, fasting blood sugar (FBS), post-prandial blood sugar (PP2BS), glycated hemoglobin (HbA1c), and the duration of diabetes. Conclusion A high MPV was linked to poor glycemic control, a longer duration of diabetes, and an increased prevalence of vascular complications. Hence, MPV could be used as a cost-effective marker to predict vascular complications in patients with type 2 DM.
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Andrei CL, Catană A, Sinescu CJ, Mirică A, Ceban O, Chioncel VP, Darabont RO. Mean Platelet Volume: A Possible Predictor for Patients with Decompensated Chronic Heart Failure. Int J Gen Med 2022; 15:4131-4140. [PMID: 35465307 PMCID: PMC9020575 DOI: 10.2147/ijgm.s362257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 04/06/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Despite all medical efforts and discoveries, heart failure (HF) remains one of the most important and common public health problems, with high mortality and hospitalization rates, due to decompensation of HF. In the present study, we aimed to identify a predictive factor through which we can evaluate the risk of readmission and mortality in the first year, given the initial admission of a patient with decompensated heart failure. Patients and Methods The parameter we have investigated is the mean platelet volume (MPV). Studies have shown that there is a significant correlation between the value of MPV and the risk of cardiovascular disease (CVD) and cardiovascular (CV) death. In this study, we enrolled 130 patients hospitalized for decompensated chronic HF (NYHA class IV HF or acute pulmonary edema) and analyzed whether there is a relationship between the value of the MPV at admission and 6-month rehospitalization, and 1-year mortality, respectively. Results The statistical analysis revealed significantly different values (p = 0.041) for MPV at admission between the group of patients without decompensated chronic HF compared to the group of patients with decompensated chronic HF (8.74 fl vs 9.08 fl). Also, the results of our study revealed that patients with decompensated chronic heart failure who were readmitted at 6 months and died at 1 year, respectively, had a higher MPV at admission (>9 fl), compared to those without the above-mentioned events, with a statistical significance. Conclusion A higher MPV at admission can be considered in our study as an independent predictor for rehospitalization and 1-year mortality of patients with decompensated chronic HF.
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Affiliation(s)
| | - Andreea Catană
- University of Medicine and Pharmacy “Carol Davila”, Bucharest, Romania
- Correspondence: Andreea Catană, University of Medicine and Pharmacy “Carol Davila”, Dionisie Lupu Street, no. 37, Bucharest, 020021, Romania, Tel +40-745469489, Email ;
| | | | - Andreea Mirică
- The Bucharest University of Economic Studies, Bucharest, Romania
| | - Octavian Ceban
- The Bucharest University of Economic Studies, Bucharest, Romania
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Fragão-Marques M, Rocha-Neves J, Andrade JP. Response to the letter "Mean platelet volume may not predict restenosis after carotid endarterectomy" from Beyan C. and Beyan E. Ann Vasc Surg 2022; 83:e6-e7. [PMID: 35337928 DOI: 10.1016/j.avsg.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Mariana Fragão-Marques
- - Department of Surgery and Physiology, Faculdade de Medicina da Universidade do Porto, Portugal; - Department of Clinical Pathology, Centro Hospitalar Universitário de São João, Porto, Portugal; - Cardiovascular R&D Unit, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - João Rocha-Neves
- - Department of Biomedicine - Unit of Anatomy, Faculdade de Medicina da Universidade do Porto, Portugal; - Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | - José P Andrade
- - Department of Angiology and Vascular Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal; - Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Platelet distribution width: A significant predictor of poor outcome after mechanical thrombectomy. J Stroke Cerebrovasc Dis 2021; 31:106273. [PMID: 34974240 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/06/2021] [Accepted: 12/09/2021] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Elevated platelet distribution width (PDW) is a recognized marker of platelet activity. Herein, we investigated the association between admission PDW values and clinical outcome at 3 months in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS We retrospectively collected consecutive patients diagnosed with AIS following MT from two stroke centers. PDW was measured on admission. Subjects were divided into two groups according to the clinical outcome using the modified Rankin Scale at 3 months. Multiple regression analyses and receiver operating characteristic (ROC) curves were performed to determine the associations between admission PDW values, clinical parameters, and functional outcome. RESULTS A total of 162 subjects were enrolled. Patients in the poor outcome group had a significantly higher percentage of PDW >16.0 fL compared with the good outcome group (57.3% vs. 26.9%, P < 0.001). After adjusting for a range of confounding factors, multiple regression analysis showed that PDW >16.0 fL was an independent predictor of poor outcome at 3 months (odds ratio 4.572, 95% confidence interval 1.896-11.026, P = 0.001). ROC curve analysis revealed that PDW >16.0 fL predicted poor outcome with 57.3% sensitivity and 73.1% specificity (the area under the ROC curve 0.637, 95% confidence interval 0.558-0.711, P = 0.004). CONCLUSIONS Elevated PDW is an independent predictor of poor functional outcome in patients with anterior circulation AIS undergoing MT at 3 months.
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Ot S, Zafar L, Beg M, Siddiqui OA. Association of Mean Platelet Volume with Risk Factors and Functional Outcome in Acute Ischemic Stroke. J Neurosci Rural Pract 2021; 12:764-769. [PMID: 34737513 PMCID: PMC8558973 DOI: 10.1055/s-0041-1735326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background
Stroke is the second leading cause of death in the world and a major cause of disability, with ischemic stroke contributing to 87% of all strokes. Platelets are central in the formation of thrombus, and in the process, they enlarge in size, become active, and secrete prothrombotic factors. This is supported by the presence of large platelets in ischemic stroke, where they may be implicated in the pathogenesis of vessel occlusion, leading to stroke. The mean platelet volume (MPV) is an important laboratory marker of platelet function and activation.
Materials and Methods
The present study was conducted to assess the role of MPV in the pathogenesis, severity, and outcome of ischemic stroke. It was an observational study in 100 acute ischemic stroke (AIS) patients (excluding cardioembolic stroke) admitted to the Medicine wards, Department of Medicine, Jawaharlal Nehru Medical College, a tertiary care hospital at Aligarh. The MPV was correlated with the conventional risk factors of ischemic stroke and outcome (using modified Rankin scale [mRS]). The study revealed statistically significant correlation between MPV and hypertension, type 2 diabetes mellitus, and carotid intima media thickness (CIMT). Also, the MPV at presentation positively correlated with mRS (correlation coefficient 0.818); thus, high MPV was associated with more severe disability.
Conclusion
The MPV at the time of presentation of ischemic stroke may be useful in predicting the severity of stroke and neurological recovery. However, a larger study including diverse population is required to endorse its predictive value in AIS.
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Affiliation(s)
- Sreejith Ot
- Department of Medicine, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India
| | - Lubna Zafar
- Department of Medicine, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India
| | - Mujahid Beg
- Department of Medicine, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India
| | - Obaid Ahmed Siddiqui
- Department of Anaesthesiology and Critical Care, Jawaharlal Nehru Medical College Hospital, Aligarh, Uttar Pradesh, India
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Ghodsi H, Abouei Mehrizi MA, Khoshdel AR, Shekarchi B. Evaluation of combining Alberta Stroke Program Early CT Score (ASPECTS) with mean platelet volume, plateletcrit, and platelet count in predicting short- and long-term prognosis of patients with acute ischemic stroke. Clin Neurol Neurosurg 2021; 208:106830. [PMID: 34419782 DOI: 10.1016/j.clineuro.2021.106830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND There is controversy regarding Alberta Stroke Program Early CT Score (ASPECTS) and platelet indices as predictors of outcome in patients with acute ischemic stroke (AIS). We aimed to assess the prognostic value of ASPECTS, mean platelet volume (MPV), plateletcrit (PCT), and platelet count (Plt) in 3-month and 1-year functional outcomes of AIS patients, both independently and in combination. METHODS This prospective study was conducted in Shams Al-shomuos and Ghaem hospitals of Mashhad, Iran from June 2019 to January 2021. Overall, 553 patients above 18 years old with first-ever anterior circulation AIS met the eligibility criteria and were included. Clinical, hematologic, radiologic, and demographic data of patients were recorded at baseline. The 3-month and 1-year functional outcome was evaluated by modified Rankin Scale (mRS). Multivariate logistic regression was used to determine the independent predictors of poor functional outcome (mRS>2) and mortality. RESULTS The mean age of the patients was 65.50 ± 14.41 years and 282 patients (51%) were male. ASPECTS ≤ 7 was an independent predictor of both poor function (OR=1.94, 95%CI=1.04-3.62, P = 0.04) and mortality (OR=2.02, 95%CI=1.14-3.58, P = 0.02) at 1 year. MPV was also a strong predictor of 3-month (OR=3.88, 95%CI=2.04-7.38, P = 0.02) and 1-year (OR=3.32, 95%CI=1.91-5.78, P = 0.01) mortality, as well as 3-month (OR=3.25, 95%CI=1.80-5.86, P < 0.001) and 1-year (OR=4.35, 95%CI=2.36-8.02, P < 0.001) poor function. For 1-year poor function (OR=9.33, 95%CI=2.19-39.73, P = 0.003) and mortality (OR=6.40, 95%CI=2.09-19.64, P = 0.001), ASPECTS combined with all platelet indices found to be a more robust independent predictor compared to each variable alone. CONCLUSION Although MPV is an independent predictor of both 3-month and 1-year poor function and mortality in AIS patients, ASPECTS ≤ 7 was found to be a risk factor for 1-year poor function and mortality. Moreover, the prognostic value of both platelet indices and ASPECTS are greater when they are combined together in AIS patients.
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Affiliation(s)
- Hamidreza Ghodsi
- Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Reza Khoshdel
- Modern Epidemiology Research Center, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Babak Shekarchi
- Department of Radiology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
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Objective and Measurable Biomarkers in Chronic Subjective Tinnitus. Int J Mol Sci 2021; 22:ijms22126619. [PMID: 34205595 PMCID: PMC8235100 DOI: 10.3390/ijms22126619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/18/2022] Open
Abstract
Tinnitus is associated with increased social costs and reduced quality of life through sleep disorders or psychological distress. The pathophysiology of chronic subjective tinnitus, which accounts for most tinnitus, has not been clearly elucidated. This is because chronic subjective tinnitus is difficult to evaluate objectively, and there are no objective markers that represent the diagnosis or therapeutic effect of tinnitus. Based on the results of studies on patients with chronic subjective tinnitus, objective and measurable biomarkers that help to identify the pathophysiology of tinnitus have been summarized. A total of 271 studies in PubMed, 303 in EMBASE, and 45 in Cochrane Library were found on biomarkers related to chronic subjective tinnitus published until April 2021. Duplicate articles, articles not written in English, review articles, case reports, and articles that did not match our topic were excluded. A total of 49 studies were included. Three specimens, including blood, saliva, and urine, and a total of 58 biomarkers were used as indicators for diagnosis, evaluation, prognosis, and therapeutic effectiveness of tinnitus. Biomarkers were classified into eight categories comprising metabolic, hemostatic, inflammatory, endocrine, immunological, neurologic, and oxidative parameters. Biomarkers can help in the diagnosis, measure the severity, predict prognosis, and treatment outcome of tinnitus.
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Zhang X, Jin Q, Hu J, Kong D, Pan C, Chen D, Chen S, Li MI, Zhou D, Ge J. Impact of Thrombocytopenia in Patients With Atrial Fibrillation Undergoing Left Atrial Appendage Occlusion: A Propensity-Matched Comparison of 190 Consecutive Watchman Implantations. Front Cardiovasc Med 2021; 8:603501. [PMID: 33898533 PMCID: PMC8062722 DOI: 10.3389/fcvm.2021.603501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The purpose of this study was to provide data on the long-term efficacy and safety of left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF) and chronic thrombocytopenia (cTCP). Methods: Between January 2016 and December 2018, a total of 32 AF patients with thrombocytopenia (platelet count <100*10∧9/L) undergoing LAAO at our center were identified and their outcomes were compared with a propensity-matched cohort (match ratio 1:5) of patients without cTCP who had also been indicated for LAAO. Results: Between the cTCP patients and the control group, no difference was found on the incidence of stroke (0 vs. 3.13%, p = 0.592), systematic thromboembolisation (0 vs. 0.63%, p > 0.9) and device-related thrombus (DRT) (3.13 vs. 2.50%, p > 0.9). Major (12.50 vs. 3.75%, p = 0.065) and minor bleeding (15.63 vs. 1.25%, p = 0.002) was more frequent in cTCP patients but no statistical difference was reached in major bleeding. Moreover, thrombocytopenia was also identified as an independent predictor of any bleeding events (OR: 8.150, 95% CI: 2.579–25.757, p < 0.001), while an inverse relationship between higher absolute platelet count and stroke events was revealed (OR: 1.015; 95% CI: 1.002~1.029, p = 0.022). However, in both groups we saw a significant reduction in observed annualized rates of non-procedural complications compared with the predicted values. In the cTCP and control groups, clinical thromboembolism was reduced by 100 and 74.32%, and major bleeding by 42.47 and 71.67%, respectively. Conclusion: Our preliminary results indicate that LAAO using the Watchman device could be a safe and effective means of preventing stroke in AF patients with or without thrombocytopenia, but bleeding complications should be monitored intensively in cTCP patients.
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Affiliation(s)
- Xiaochun Zhang
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Qinchun Jin
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Dehong Kong
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Cuizhen Pan
- National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Dandan Chen
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Shasha Chen
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - MIngfei Li
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Daxin Zhou
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai, China.,Research Unit of Cardiovascular Techniques and Devices, Chinese Academy of Medical Sciences, Beijing, China
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Mean Platelet Volume is a Prognostic Marker in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. J Stroke Cerebrovasc Dis 2021; 30:105718. [PMID: 33838517 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105718] [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: 12/07/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is conflicting data regarding the association between platelet parameters and prognosis of stroke patients treated with intravenous thrombolysis. We aimed to analyze this association in a cohort of patients treated with rtPA. MATERIAL AND METHODS Retrospective, observational study in adult ischemic stroke patients treated with rtPA between January 2015 and February 2017. Demographic and clinical characteristics, stroke severity (NIHSS), etiology (TOAST), mean platelet volume (MPV), platelet count (PC), platelet distribution width (PDW) and functional outcome (mRS) at discharge and 90 days were recorded. The association between platelet parameters and unfavorable prognosis (mRS 3-6) was tested using non-parametric tests and logistic regression analysis. RESULTS 267 patients were included, 134 (50.2%) females, with a median (IQR) age of 74 years (64-82). The median admission NIHSS was 14 (8-19) and the most frequent etiology was cardioembolism (n = 115, 43.1%). At discharge, 170 (63.7%) patients had mRS 3-6. MPV values were higher in patients with mRS 3-6 (median 8.2fL versus 7.8fL, p = 0.013). This association remained significant (OR = 1.36, 95% CI 1.003-1.832, p = 0.048) after adjustment for variables associated with prognosis. There were no significant associations between other platelet parameters and prognosis. There was a trend to unfavorable prognosis at 90 days in patients with higher MPV. Regarding the association between platelet parameters and hemorrhagic transformation, higher PDW was associated with more severe hemorrhagic transformation (PH1/PH2). CONCLUSIONS Higher MPV values were associated with unfavorable prognosis at discharge in patients treated with intravenous thrombolysis. Future studies should address its added value in stroke prediction models.
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ATİK D, CANDER B, YAZICI R, BULUT B, ÜNAL R, SERT E. Evaluation of the relation of Platelet Volume Index, MPV and RDW values with mortality in spontaneous intraparenchymal hemorrhages. FAMILY PRACTICE AND PALLIATIVE CARE 2021. [DOI: 10.22391/fppc.817258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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An I, Ayhan E, Aksoy M, Ozturk M, Erat T, Doni NY. Evaluation of inflammatory parameters in patients with cutaneous leishmaniasis. Dermatol Ther 2020; 34:e14603. [PMID: 33249697 DOI: 10.1111/dth.14603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Abstract
Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease characterized by various skin lesions that can cause deformities when healed. Our aim in this study is to show the utility of parameters such as neutrophil/lymphocyte ratio (NLR), thrombocyte/lymphocyte ratio (TLR), and mean thrombocyte volume (MTV) as auxiliary laboratory methods in CL patients. About 107 patients who were admitted to our dermatological and venereal diseases outpatient clinic between January 2018 and January 2019 and were diagnosed with CL by microscopic examination and 74 healthy individuals were included in the study. There were no significant differences between the patient and control group in terms of neutrophil counts, leukocyte counts, platelet counts, and NLR values (P values: .271, .053, .263, and .459, respectively). When the TLR and MTV values of patients with CL and those of the healthy controls were compared, it was found that TLR and MTV values were statistically higher in patients with CL (P values of .010 and .044, respectively). Based on these data, NLR was not considered to be a suitable parameter for demonstrating inflammation in CL patients, but TLR and MTV were held to be an appropriate parameter for demonstrating inflammation in CL patients. In addition, we think that the increase in MTV and TLR, can be used as an auxiliary laboratory test in the diagnosis of CL disease.
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Affiliation(s)
- Isa An
- Department of Dermatology, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Erhan Ayhan
- Department of Dermatology, University of Health Sciences Gazi Yaşargil Trainning and Research Hospital, Diyarbakır, Turkey
| | - Mustafa Aksoy
- Department of Dermatology, Harran University Medical Faculty, Sanlıurfa, Turkey
| | - Murat Ozturk
- Department of Dermatology, Van Training and Research Hospital, Van, Turkey
| | - Tugba Erat
- Department of Pediatric Infectious Diseases, Sanlıurfa Training and Research Hospital, Sanlıurfa, Turkey
| | - Nebiye Yentur Doni
- Department of Microbiology, Harran University Medical Faculty, Sanlıurfa, Turkey
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Miceli A. Reply: Look deeper into thrombocytopenia. J Thorac Cardiovasc Surg 2020; 161:S0022-5223(20)32152-8. [PMID: 32868056 DOI: 10.1016/j.jtcvs.2020.07.029] [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: 07/06/2020] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Antonio Miceli
- Minimally Invasive Cardiac Surgery Department, Istituto Clinico Sant'Ambrogio, Milan, Italy
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Mean Platelet Volume/Lymphocyte Ratio as a Prognostic Indicator for HBV-Related Decompensated Cirrhosis. Gastroenterol Res Pract 2020; 2020:4107219. [PMID: 32714387 PMCID: PMC7352138 DOI: 10.1155/2020/4107219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/09/2020] [Accepted: 06/19/2020] [Indexed: 12/30/2022] Open
Abstract
Aim To evaluate the prognostic role of the mean platelet volume/lymphocyte ratio (MPVLR) for mortality in patients with hepatitis B virus-related decompensated cirrhosis (HBV-DeCi). Methods The medical records of 101 patients with HBV-DeCi were retrospectively reviewed, and their baseline clinical and laboratory characteristics were extracted. The predictive value of the MPVLR for death was estimated using receiver operating characteristic curve analysis and a multivariate logistic regression model. Results Patients with HBV-DeCi in the high-MPVLR group exhibited significantly increased 90-day mortality compared with that of the patients within the low-MPVLR group, and MPVLR was an independent predictor of 90-day mortality in patients with HBV-DeCi. Conclusions Increased MPVLR is associated with poor outcomes in patients with HBV-DeCi and might be a useful component of future prognostic scores.
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Mean platelet volume and mechanical thrombectomy. J Stroke Cerebrovasc Dis 2020; 29:104971. [PMID: 32689585 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE Mean Platelet Volume (MPV) is a marker of platelet activity and it is an independent predictor for long-term outcome in stroke patients. The aim of this study was to evaluate the association between baseline MPV value and clinical outcome at 90-days in anterior circulation stroke and large vessel occlusion (LVO) patients submitted to mechanical thrombectomy (MT). METHODS We conducted a prospective observational cohort study in acute ischemic stroke (AIS) patients submitted to MT between January 2017 and May 2018. MPV was measured at admission. Patients were initially stratified into two groups according to the mean MPV level. We also compared groups that were stratified according to the MPV cut-off obtained by Peng F et al (10,4 fL) and performed analyses among MPV terciles. RESULTS A total of 129 patients were included. Mean level of MPV was 10,9 fL. Patients with embolic stroke of undetermined source (ESUS) had significantly higher rates of good outcome at 3 months compared with large-artery atherosclerotic disease and cardioembolism [(82,9%) vs (78,3%) vs (55,2%); p=0,009]. There were no statistically significant differences in the mean MPV value (p=0,222), successful recanalization (p=0,464) and mortality (p=0,343) when evaluated for all TOAST etiologies. There were no statistically significant differences between the two groups according to the MPV level (10,4 and 10,9 fL) or between the terciles (lowest tertile <10,3 fL, median 10,3 - 11,3 fL, highest >11,3fL) concerning functional outcome at 3 months (p=0,357; p=0,24 and p=0,558, respectively), successful recanalization (p=0,108; p=0,582 and p=0,899, respectively) or mortality at 3 months (p=0,465; p=0,061 and p=0,484, respectively). CONCLUSION Our study did not find an association between elevated MPV and worse outcome at 3 months in patients with acute anterior circulation stroke and LVO treated with MT. Since ischemic strokes have different pathophysiologic mechanisms, MPV may have distinct prognostic value according to each stroke etiology.
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Zhu N, Shu H, Jiang W, Wang Y, Zhang S. Mean platelet volume and mean platelet volume/platelet count ratio in nonvalvular atrial fibrillation stroke and large artery atherosclerosis stroke. Medicine (Baltimore) 2020; 99:e21044. [PMID: 32664115 PMCID: PMC7360237 DOI: 10.1097/md.0000000000021044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Ischemic stroke subtypes such as patients with large artery atherosclerosis, cardioembolism, and embolic stroke of undetermined source were investigated. This study was performed aimed to determine mean platelet volume (MPV) and mean platelet volume/platelet count (MPV/Plt) ratio in nonvalvular atrial fibrillation (AF) stroke and large artery atherosclerosis (LAA) stroke.We conducted a retrospective study of consecutive patients for treatment of acute ischemic stroke at Ruian People's Hospital from March 2017 to October 2018. The patients with ischemic stroke caused by AF and LAA were recruited to this study. Ischemic stroke was confirmed by magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), ischemic lesions on diffusion-weighted imaging were measured in terms of size, composition, and pattern. MPV and platelet count were examined and (MPV/Plt) ratio was calculated.Three hundred seventy one patients were enrolled composing of 177 (47.7%) nonvalvular AF and 194 (52.2%) with LAA. The MPV (11.3 ± 1.3 vs 10.8 ± 1.0, P < .001) and MPV/Plt ratio (0.066 ± 0.025 vs 0.055 ± 0.20, P < .001) were much higher in AF group than LAA group. Receiver-operating characteristic (ROC) analysis showed MPV (AUC: 0.624, confidence interval: 0.567-0.68, P < .001) and MPV/Plt (AUC: 0.657, confidence interval: 0.601-0.713, P < .001) predicted AF between the 2 groups. MPV/Plt ratio was negatively associated with lesion volume (r = -0.161, P = .033) in AF. The analyses of subtypes of composition of infarcts and infarct pattern showed that MPV/Plt ratio was almost higher in AF than LAA except for subcortical-only pattern. Multivariable regression analyses demonstrated National Institutes of Health Stroke Scale (NIHSS) score (r = 2.74; P < .001), LAD (r = -1.15; P = .025) and MPV/Plt ratio (r = -180.64; P = .021) were correlated with lesion volume.Our results indicated elevated MPV and MPV/Plt ratio for the identification of difference between AF and LAA in patients with ischemic stroke.
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Affiliation(s)
- Ning Zhu
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Hao Shu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian People's Hospital, Ruian, Zhejiang Province, P.R. China
| | - Wenbing Jiang
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Yi Wang
- Department of Cardiology, The Wenzhou Third Clinical Institute Affiliated To Wenzhou Medical University, Wenzhou People's Hospital, Wenzhou
| | - Shunkai Zhang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Ruian People's Hospital, Ruian, Zhejiang Province, P.R. China
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Miller MM, Henninger N, Słowik A. Mean platelet volume and its genetic variants relate to stroke severity and 1-year mortality. Neurology 2020; 95:e1153-e1162. [PMID: 32576634 DOI: 10.1212/wnl.0000000000010105] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/28/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To determine whether mean platelet volume (MPV) and selected single nucleotide polymorphisms (SNPs) that have been associated with MPV in genome-wide association studies relate to stroke severity, functional outcome on discharge, and 1-year mortality in patients with ischemic stroke, we retrospectively analyzed 577 patients with first-ever ischemic stroke. METHODS Genotyping of 3 SNPs (rs342293, rs1354034, rs7961894) was performed using a real-time PCR allelic discrimination assay. Multivariable regression was used to determine the association of MPV and MPV-associated SNPs with the NIH Stroke Scale (NIHSS) score on admission, modified Rankin Scale score on discharge, and data on 1-year mortality. RESULTS Rs7961894, but not rs342293 or rs1354034 SNP, was independently associated with an MPV in the highest quartile (MPV Q4). MPV Q4 was associated with significantly greater admission NIHSS (p = 0.006), poor discharge outcome (p = 0.034), and worse 1-year mortality (p = 0.033). After adjustment for pertinent covariates, MPV Q4 remained independently associated with a greater admission NIHSS score (p = 0.025). The T>C variant of rs7961894 SNP was an independent marker of a lower 1-year mortality (hazard ratio, 0.30; 95% confidence interval, 0.13-0.70; p = 0.006) in the studied population. CONCLUSION MPV is a marker of stroke severity and T>C variant of rs7961894 is independently associated with greater MPV in acute phase of ischemic stroke and relates to decreased 1-year mortality after stroke.
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Affiliation(s)
- Małgorzata M Miller
- From the Department of Neurology (M.M.M., A.S.), Jagiellonian University Medical College, Krakow, Poland; and Departments of Neurology and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester.
| | - Nils Henninger
- From the Department of Neurology (M.M.M., A.S.), Jagiellonian University Medical College, Krakow, Poland; and Departments of Neurology and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester
| | - Agnieszka Słowik
- From the Department of Neurology (M.M.M., A.S.), Jagiellonian University Medical College, Krakow, Poland; and Departments of Neurology and Psychiatry (N.H.), University of Massachusetts Medical School, Worcester
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Jackson BS, Nunes Goncalves J, Pretorius E. Comparison of pathological clotting using haematological, functional and morphological investigations in HIV-positive and HIV-negative patients with deep vein thrombosis. Retrovirology 2020; 17:14. [PMID: 32571345 PMCID: PMC7310079 DOI: 10.1186/s12977-020-00523-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 06/16/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Patients infected with the human immunodeficiency virus (HIV) are more prone to systemic inflammation and pathological clotting, and many may develop deep vein thrombosis (DVT) as a result of this dysregulated inflammatory profile. Coagulation tests are not routinely performed unless there is a specific reason. METHODS We recruited ten healthy control subjects, 35 HIV negative patients with deep vein thrombosis (HIV negative-DVT), and 13 HIV patients with DVT (HIV positive-DVT) on the primary antiretroviral therapy (ARV) regimen-emtricitabine, tenofovir and efavirenz. Serum inflammatory markers, haematological results, viscoelastic properties using thromboelastography (TEG) and scanning electron microscopy (SEM) of whole blood (WB) were used to compare the groups. RESULTS The DVT patients (HIV positive and HIV negative) had raised inflammatory markers. The HIV positive-DVT group had anaemia in keeping with anaemia of chronic disorders. DVT patients had a hypercoagulable profile on the TEG but no significant difference between HIV negative-DVT and HIV positive-DVT groups. The TEG analysis compared well and supported our ultrastructural results. Scanning electron microscopy of DVT patient's red blood cells (RBCs) and platelets demonstrated inflammatory changes including abnormal cell shapes, irregular membranes and microparticle formation. All the ultrastructural changes were more prominent in the HIV positive-DVT patients. CONCLUSIONS Although there were trends that HIV-positive patients were more hypercoagulable on functional tests (viscoelastic profile) compared to HIV-negative patients, there were no significant differences between the 2 groups. The sample size was, however, small in number. Morphologically there were inflammatory changes in patients with DVT. These ultrastructural changes, specifically with regard to platelets, appear more pronounced in HIV-positive patients which may contribute to increased risk for hypercoagulability and deep vein thrombosis.
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Affiliation(s)
- Brandon S Jackson
- Department of Surgery, University of Pretoria, Pretoria, 0007, South Africa
| | | | - Etheresia Pretorius
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, Private Bag X1 Matieland, 7602, South Africa.
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Pan H, Fu M, Ge W, Zhou C. The effects of changes in platelet-to-neutrophil ratios 24 hours after intravenous thrombolysis on prognosis in acute ischemic stroke patients. Clin Neurol Neurosurg 2020; 190:105739. [PMID: 32105907 DOI: 10.1016/j.clineuro.2020.105739] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 02/03/2020] [Accepted: 02/16/2020] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To investigate the prognostic value of Platelet-to-Neutrophil ratio on admission (PNR on admission) and 24 h after intravenous thrombolysis (24 h PNR) in acute ischemic stroke patients (AIS) patients. PATIENTS AND METHODS One hundred fifty-one ischemic stroke patients receiving intravenous thrombolysis were retrospectively recruited in this study. Complete blood count evaluations for PNR were conducted on admission and 24 h after the treatment of thrombolysis. The poor outcome at 3months was defined as the modified Rankin Scale of 3-6. RESULTS In multivariate logistic regression, PNR on admission (odds ratio [OR] = 0.967, 95 % confidence interval [CI] = 0.939-0.996; P = 0.028), and 24 h PNR(OR = 0.933, 95 %CI = 0.895-0.972; P = 0.004) were all independent indicators for the 3-month poor prognosis in ischemic stroke patients receiving intravenous thrombolysis. The area under the curve of PNR on admission to predict poor functional outcomes at 3 months was 0.645 (95 %CI = 0.558-0.732; P < 0.001), and the best predictive PNR on admission value was 41.35. After the treatment of thrombolysis, the area under the curve of 24 h PNR to predict poor functional outcomes at 3 months was 0.796 (95 %CI = 0.722-0.858; P < 0.001), and the best predictive 24 h PNR value was 31.03. CONCLUSIONS Both the PNR on admission and 24 h PNR were independently associated with poor functional outcomes. Compared with the PNR on admission, 24 h PNR may serve as a more reliable marker for a poor prognosis in ischemic stroke patients receiving intravenous thrombolysis.
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Affiliation(s)
- Hong Pan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Mei Fu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Wanqian Ge
- Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Chengye Zhou
- Department of Rehabilitation, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
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Ghaffari S, Parvizian N, Pourafkari L, Separham A, Hajizadeh R, Nader ND, Javanshir E, Sepehrvand N, Tajlil A, Nasiri B. Prognostic value of platelet indices in patients with acute pulmonary thromboembolism. J Cardiovasc Thorac Res 2020; 12:56-62. [PMID: 32211139 PMCID: PMC7080337 DOI: 10.34172/jcvtr.2020.09] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 01/24/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P= 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes.
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Affiliation(s)
- Samad Ghaffari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nashmil Parvizian
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Anesthesiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Ahmad Separham
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Hajizadeh
- Department of Cardiology, Urmia University of Medical Sciences, Urmia, Iran
| | - Nader D Nader
- Department of Anesthesiology, State University of New York at Buffalo, Buffalo, NY, USA
| | - Elnaz Javanshir
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nariman Sepehrvand
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Arezou Tajlil
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Nasiri
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Chen SY, Lin YS, Cheng YF, Wang H, Niu XT, Zhang WL. Mean Platelet Volume-To-Lymphocyte Ratio Predicts Poor Functional Outcomes Among Ischemic Stroke Patients Treated With Intravenous Thrombolysis. Front Neurol 2020; 10:1274. [PMID: 31920909 PMCID: PMC6914757 DOI: 10.3389/fneur.2019.01274] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 11/18/2019] [Indexed: 12/22/2022] Open
Abstract
Background and Purpose: According to previous studies, the mean platelet volume-to-lymphocyte ratio (MPVLR) represents a novel marker of a poor short-term prognosis in patients with a myocardial infarction who underwent primary percutaneous coronary intervention. We aimed to evaluate the association between MPVLR and clinical outcomes of patients with acute ischemic stroke who were treated with intravenous thrombolysis. Methods: Two hundred forty-one patients with ischemic stroke receiving intravenous thrombolysis were prospectively enrolled in this study. Blood samples for MPVLR were obtained at admission and at 18-24 h after treatment with intravenous thrombolysis. A poor functional outcome was defined as a modified Rankin scale score of 3-6 at 3 months after stroke. Results: At admission, the area under the curve of MPVLR to predict poor functional outcomes at 3 months was 0.613 [95% confidence interval (CI), 0.541-0.686; P = 0.003), and the best predictive MPVLR value was 5.8. Patients with an MPVLR ≥5.8 had a 3.141-fold increased risk of a poor outcome at 3 months (95% CI, 1.491-6.615; P = 0.003) compared to patients with an MPVLR <5.8. At 18-24 h after treatment with intravenous thrombolysis, the area under the curve of MPVLR to predict a poor outcome at 3 months was 0.697 (95% CI, 0.630-0.765, P < 0.001), and the best predictive MPVLR value was 6.9. The inclusion of MPVLR as a continuous (odds ratio, 1.145; 95% CI, 1.044-1.256, P = 0.004) and categorical variable (odds ratio, 6.555; 95% CI, 2.986-14.393, P < 0.001) was independently associated with poor outcomes at 3 months. Conclusions: Both the values of MPVLR at admission and 18-24 h after intravenous thrombolysis were independently associated with poor functional outcomes. MPVLR may serve as an activity marker for a poor prognosis in patients with acute ischemic stroke receiving intravenous thrombolysis.
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Affiliation(s)
- Si-Yan Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yuan-Shao Lin
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-Fan Cheng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Wang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao-Ting Niu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wan-Li Zhang
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Go H, Ohto H, Nollet KE, Takano S, Kashiwabara N, Chishiki M, Maeda H, Imamura T, Kawasaki Y, Momoi N, Hosoya M. Using Platelet Parameters to Anticipate Morbidity and Mortality Among Preterm Neonates: A Retrospective Study. Front Pediatr 2020; 8:90. [PMID: 32232019 PMCID: PMC7082741 DOI: 10.3389/fped.2020.00090] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/21/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Platelets participate in many physiological and pathological functions and some platelet parameters predict adult diseases. However, few studies report whether platelet parameters may reflect neonatal disease and mortality in a large cohort. Objective: We aimed to investigate whether platelet parameters could predict bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), and NICU mortality. Study Design and Methods: This retrospective cohort study examined records from 2006 to 2017 at the neonatal intensive care unit (NICU) of Fukushima Medical University Hospital. We retrospectively investigated platelet count, plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW) on the first day of life in preterm newborns born <32 weeks' gestation admitted to our NICU from 2006 to 2017. Receiver operating characteristic (ROC) and multiple regression analyses, along with Cox proportional hazard modeling, identified independent predictors of morbidities and mortality in preterm newborns. Results: Of 1,501 neonates admitted to our NICU, a total of 305 preterm newborns were included in this study. Gestational age, birth weight, and Apgar score were significantly lower in non-survivors than in survivors. Platelet count, PCT, PDW and PMI did not differ significantly between the two groups, whereas mean MPV in non-survivors was significantly higher than in survivors (10.5 fl vs. 10.0 fl, p = 0.001). Multivariate Cox hazard modeling showed that shorter GA [HR: 0.628, 95% CI: 0.464-0.840, p = 0.003], male sex [HR: 0.269, 95% CI: 0.113-0.640, p = 0.001], and MPV [HR: 1.469, 95% CI: 1.046-2.063, p = 0.026] independently predicted overall survival. Per receiver operating curve, an MPV threshold of 10.2 fl. MPV predicts prognosis in neonates with a sensitivity of 72.4% and a specificity of 58.6% (AUC = 0.685, 95% CI: 0.600-0.789, p = 0.001). Furthermore, multivariate analysis revealed that platelet parameters were not associated with BPD and NEC, whereas small for gestational age (SGA), Apgar score at 5 min, and low PCT were associated with intraventricular hemorrhage (IVH). Conclusion: This study demonstrates that low PCT predicts IVH, and MPV ≥ 10.2 fL correlates with mortality among infants born after <32 weeks' gestation.
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Affiliation(s)
- Hayato Go
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hitoshi Ohto
- Department of Advanced Cancer Immunotherapy, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kenneth E Nollet
- Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shunya Takano
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nozomi Kashiwabara
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mina Chishiki
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hajime Maeda
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Imamura
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yukihiko Kawasaki
- Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nobuo Momoi
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan
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Bedel C, Korkut M. The relationship of clinical and laboratory factors with acute isolated vertigo and cerebellar infarction. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2020. [DOI: 10.4103/injms.injms_14_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wang C, Wang L, Deng L, Qiu S, Zhang S, Liu M, Wu B. Association Between Mean Platelet Volume and Hemorrhagic Transformation in Acute Ischemic Stroke Patients. Curr Neurovasc Res 2019; 17:3-10. [PMID: 31878855 DOI: 10.2174/1567202617666191226115518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/10/2019] [Accepted: 11/20/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hemorrhagic transformation (HT) is a frequent complication of acute ischemic stroke (AIS). Mean platelet volume (MPV) is a marker of platelet function. The relationship between MPV and HT remains unclear. METHODS From January 1st, 2012 to December 31st 2016, we consecutively enrolled AIS patients admitted to the Department of Neurology of West China Hospital. MPV was measured on admission. HT was diagnosed by brain imaging and classified into hemorrhagic infarct (HI) and parenchymal hematoma (PH). Moreover, subjects were divided into tertiles according to MPV levels. Confounders were identified by univariate analysis and multivariate logistic regression was performed to explore the association between MPV and HT as well as HT subtypes. Also, a generalized additive model was used to investigate whether a non-linear association existed between MPV and HT. RESULTS A total of 783 AIS patients were included. 63 patients (8.0%) developed HT: 34 (4.3%) HI and 29 (3.7%) PH. It was observed that MPV positively correlated with HT. After adjustment for confounders, patients in the highest MPV tertile had a significantly increased risk of HT compared to patients in the lowest tertile (odds ratio 2.3, 95% confidence interval 1.0-5.4, P=0.04). The risk of HT increased step-wise across MPV tertiles (P for trend=0.04). MPV tertiles significantly correlated with HI rather than PH. The generalized additive model demonstrated a nonlinear association between MPV and HT (P=0.02). CONCLUSION The risk of HT increased with increasing MPV level in a dose-dependent manner. Patients with elevated MPV levels were more likely to develop HI rather than PH.
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Affiliation(s)
- Changyi Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Wang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Linghui Deng
- National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shi Qiu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Center of Biomedical Big Data, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shihong Zhang
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Liu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Wu
- Center of Cerebrovascular Diseases, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Dahshan A, Ebraheim AM, Rashed LA, Farrag MA, El Ghoneimy AT. Evaluation of inflammatory markers and mean platelet volume as short-term outcome indicators in young adults with ischemic stroke. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2019. [DOI: 10.1186/s41983-019-0123-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Studying outcome predictors in patients with onset of cerebral infarction in early adult life may enhance our knowledge of disease pathophysiology and prognosis.
Aim
The aim is to identify independent predictors of short-term outcome of first-ever ischemic stroke in young adults with special emphasis on inflammatory and thrombogenic markers.
Methods
We enrolled 33 patients aged 19–44 years with first-ever ischemic stroke admitted to Kasr Alainy Stroke Unit and 33 matched controls. Clinical, radiological, and laboratory (adhesion molecules, C-reactive protein, prolactin, and mean platelet volume) evaluations were carried out. Functional outcome at 7 days after stroke onset was assessed using the modified Rankin scale, and independent predictors were identified.
Results
The most frequently identified risk factor was cardiac abnormality. Patients exhibited significantly higher levels of baseline inflammatory and thrombogenic markers compared with controls. These markers were significantly correlated with the stroke severity. Logistic regression model showed that high National Institutes of Health Stroke Scale (NIHSS) score (odds ratios [OR] = 0.13; 95% confidence interval [CI], 0.04–0.24; P = 0.01) and large infarction size (OR = 0.11; 95% CI, 0.09–0.17; P = 0.04) but not the laboratory markers were independent predictors of unfavorable outcome.
Conclusion
Our data suggested that higher NIHSS scores and large infarction size served as independent predictors of short-term unfavorable outcome, while inflammatory and thrombogenic markers did not.
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Ma Y, Zong D, Zhan Z, Li H, Dai Z, Cui Y, Luo L, Zeng Z, He C, Chen Y. Feasibility of mean platelet volume as a biomarker for chronic obstructive pulmonary disease: A systematic review and meta-analysis. J Int Med Res 2019; 47:5937-5949. [PMID: 31774003 PMCID: PMC7045686 DOI: 10.1177/0300060519887886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objective To evaluate the feasibility of mean platelet volume (MPV) as a biomarker for
chronic obstructive pulmonary disease (COPD). Methods A systematic search for studies published up to March 2019 was performed in
the PubMed and Web of Science databases. Three independent investigators
screened the titles and abstracts of including studies according to
eligibility criteria. The Newcastle–Ottawa Scale was used to assess the
quality of eligible studies, and statistical analyses were performed using
Review Manager version 5.3. Results A total of eight studies with 1230 COPD patients and 443 healthy controls
were included in our meta-analysis. No significant differences in MPV level
were identified in pairwise comparisons of the acute exacerbations of COPD
(AECOPD), stable COPD, and control groups. Furthermore, no significant
correlation was observed between MPV level and systemic inflammatory
biomarkers. Conclusions MPV does not appear to represent a suitable biomarker of disease phase or
inflammatory burden in COPD. However, future large-scale studies should be
performed to further investigate the relationship between MPV and COPD.
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Affiliation(s)
- Yiming Ma
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dandan Zong
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zijie Zhan
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Herui Li
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhongshang Dai
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanan Cui
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lijuan Luo
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zihang Zeng
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chenjie He
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Chen
- Department of Respiratory and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Mao W, Wu J. Haematologic indices in hepatitis B virus-related liver disease. Clin Chim Acta 2019; 500:135-142. [PMID: 31654630 DOI: 10.1016/j.cca.2019.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/05/2019] [Accepted: 10/07/2019] [Indexed: 02/07/2023]
Abstract
Several markers and prognostic scores have been identified for predicting the development and progression of liver disease; among them, haematological parameters (the neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio (PLR), red cell distribution width (RDW), RDW to platelet ratio (RPR), mean platelet volume (MPV), and mean corpuscular volume (MCV)) have recently gained significant interest. Compared with traditional prognostic factors, haematological indices are easy to obtain and relatively inexpensive. There is growing evidence that these haematological indices play a key role in HBV-related liver diseases and has been proposed as a predictive marker of adverse outcomes in these patients. This article focuses on discussing the diagnostic and prognostic value of the haematological indices in patients with HBV-related liver diseases.
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Affiliation(s)
- WeiLin Mao
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, PR China
| | - JianPing Wu
- Department of Clinical Laboratory, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, PR China.
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Research on Association of the Diameter of the Internal Carotid Artery Siphon and Nonarteritic Anterior Ischaemic Optic Neuropathy. J Ophthalmol 2019; 2019:7910602. [PMID: 31565427 PMCID: PMC6745138 DOI: 10.1155/2019/7910602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 07/17/2019] [Accepted: 08/09/2019] [Indexed: 11/18/2022] Open
Abstract
Objective To investigate the association of the diameter of the internal carotid artery siphon (ICAS) and nonarteritic anterior ischaemic optic neuropathy (NAION). Methods Thirty patients clinically diagnosed with NAION (unilateral affected) who presented to Beijing Friendship Hospital from January 2017 to October 2018 were selected. The eyes suffered from NAION were enrolled as the observation group, and the fellow healthy eyes were enrolled as the control group. The following indexes were measured: diameter of the ICAS and the ophthalmic artery (OA), intima-media thickness (IMT) of the internal carotid artery (ICA), degree of stenosis of the ICA and plaque formation, and hemodynamic parameters of the ICA and the short posterior ciliary arteries (SPCAs). All the values were compared between the two groups. Results The diameter of the ICAS in the observation group (0.30 ± 0.07 cm) significantly narrowed compared with that of the control group (0.32 ± 0.06 cm) (P < 0.05), but the diameter of the OA of the two groups had no significant difference. The detection rate of carotid atherosclerosis plaque, the average blood flow velocity (Vm), and the resistance index (RI) of the ICA in the observation group (46.67%, 26.81 ± 1.78 cm/s, and 0.72 ± 0.06) had significant differences compared with those of the control group (16.67%, 28.19 ± 2.75 cm/s, and 0.70 ± 0.05) (P < 0.05), but the gradings of ICA stenosis and IMT between the two groups had no significant differences. The peak systolic velocity (PSV) and the end diastolic velocity (EDV) of the SPCAs in the observation group (10.72 ± 2.88 cm/s and 3.43 ± 1.01 cm/s) were significantly lower than those of the control group (13.62 ± 3.93 cm/s and 4.59 ± 1.71 cm/s) (P < 0.05), but the RI of the SPCAs of the two groups had no significant differences. Conclusion The diameter of the ICAS has a close relationship with NAION.
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Yayla ME, İlgen U, Okatan İE, UsluYurteri E, Torgutalp M, Keleşoğlu Dinçer AB, Aydemir Gülöksüz EG, Sezer S, Turgay TM, Kınıklı G, Ateş A. Association of simple hematological parameters with disease manifestations, activity, and severity in patients with systemic sclerosis. Clin Rheumatol 2019; 39:77-83. [PMID: 31317426 DOI: 10.1007/s10067-019-04685-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 06/16/2019] [Accepted: 07/09/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION/OBJECTIVES Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and red cell distribution width (RDW) may potentially reflect inflammatory status in systemic autoimmune diseases. The aim of this study is to investigate the association between these proposed markers and disease manifestations, activity, and severity in systemic sclerosis (SSc). METHOD We conducted a cross-sectional study of 69 systemic sclerosis (SSc) patients and 50 healthy volunteers in a single center. Adult patients with SSc and healthy controls were compared in terms of NLR, MLR, MPV, RDW, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Venous blood samples were drawn after at least 8 h of fasting in the morning. Extension of skin fibrosis was evaluated by using modified Rodnan skin score (mRSS). Disease severity and activity were assessed by Medsger disease severity and European Scleroderma Trials and Research Group (EUSTAR) disease activity scores, respectively. Associations of disease manifestations, clinical, laboratory, and capillaroscopic findings, mRSS, and the disease activity and severity scores with the proposed hematological markers were evaluated. Multiple regression models were generated for significant associations. RESULTS The neutrophil number was higher (p = 0.004) and lymphocyte number was lower (p < 0.001) in SSc group compared to controls. SSc group also had higher NLR, MLR, and RDW. In multiple logistic regression, only the NLR (regression coefficient = 3.49, p = 0.031) and CRP (regression coefficient = 0.17, p = 0.037) remained significantly different between SSc and healthy control groups (Cox and Snell R2 = 0.243, Nagelkerke R2 = 0.337, p < 0.001). NLR and MLR positively correlated with mRSS, EUSTAR score, and CRP. MLR also positively correlated with Medsger score. Higher monocyte counts independently predicted higher EUSTAR and Medsger scores in multiple linear regressions. Patients with digital ulcers had higher NLR and MLR. We did not find any difference in MPV values between SSc and healthy control groups. CONCLUSIONS Globally available and inexpensive hematological tests, particularly the NLR and MLR, may be associated with vascular and cutaneous manifestations as well as disease activity and severity in SSc.Key Points• Monocyte count itself independently predicted higher activity and severity scores in SSc.• Globally available and inexpensive hematological markers, particularly the NLR and MLR, may have an association with vascular and cutaneous manifestations as well as disease activity and severity in patients with SSc.
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Affiliation(s)
- Müçteba Enes Yayla
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey.
| | - Ufuk İlgen
- Department of Rheumatology, Faculty of Medicine, Trakya University, Edirne, Turkey
| | - İlyas Ercan Okatan
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Emine UsluYurteri
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Murat Torgutalp
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | | | | | - Serdar Sezer
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Tahsin Murat Turgay
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Gülay Kınıklı
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
| | - Aşkın Ateş
- Department of Rheumatology, Faculty of Medicine, Ankara University, Sıhhıye, Ankara, Turkey
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Lok U, Gulacti U, Ekmekci B, Bulut T, Celik M. Predictive and prognostic role of mean platelet volume in patients with first-ever acute ischemic stroke. ACTA ACUST UNITED AC 2019; 22:119-126. [PMID: 28416783 PMCID: PMC5726817 DOI: 10.17712/nsj.2017.2.20160330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: To investigate any possible effects of mean platelet volume (MPV) on short-term stroke prognosis and functional outcome in patients with first-ever acute ischemic stroke (FEAIS). Methods: This retrospective cross-sectional study included 798 FEAIS patients admitted to the emergency department of a tertiary care hospital in Adiyaman, Turkey between January 2013 and June 2015. The data were evaluated according to whether alive or dead, MPV levels, modified Rankin scale (MRS) scores, National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into 3 groups based on MPV level as 4.4-7.4 fL, 7.5-10.4 fL, higher than 10.4 fL. Results: A total of 250 patients with FEAIS were included in the study. In both those who survived and those who died, the area under the curve related to hospitalization days, time interval of venipuncture (TIV), and MPV measurements was not statistically significant (p>0.05). The 3 MPV groups showed no significant differences in terms of MRS score, median NIHSS score, hospitalization, and TIV. In subgroups based on MRS scores, there were no statistically significant differences according to median latency (p=0.087), median hospitalization (p=0.394), TIV (p=0.201), and MPV levels (p=0.847). Furthermore, there were no differences in MPV levels between the MRS based groups (p=0.527). Conclusion: The results showed that MPV was not a significantly associated and reliable marker for the prediction of prognosis or functional outcome of FEAIS attack.
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Affiliation(s)
- Ugur Lok
- Departments of Emergency Medicine, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
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Wang JJ, Wang YL, Ge XX, Xu MD, Chen K, Wu MY, Gong FR, Tao M, Wang WJ, Shou LM, Li W. Prognostic Values of Platelet-Associated Indicators in Resectable Lung Cancers. Technol Cancer Res Treat 2019; 18:1533033819837261. [PMID: 30871415 PMCID: PMC6421614 DOI: 10.1177/1533033819837261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: Lung cancer is the leading cause of cancer death. Platelet-related indictors, including platelet count, plateletcrit, mean platelet volume, and platelet distribution width, not only associate with morphology and functions of platelet but also correlate with tumor development and metastasis. In the present study, we investigated the values of platelet-related indictors in the prognosis evaluation of resectable lung cancers. Methods: In total, 101 patients with resectable lung cancer were recruited in this study. Patients were divided into 2 groups according to the median pretreatment values. To evaluate the individual value changes after treatment, we introduced the concept of post-/pretreatment ratio (≤1 indicated value was not increased after treatment, while >1 suggested increased value). Results: The high pretreatment platelet count level was correlated with larger tumor size. High pretreatment plateletcrit level was associated with more lymph nodes metastasis. Patients with high pretreatment plateletcrit level had worse overall survival, whereas pretreatment platelet count, mean platelet volume, and platelet distribution width levels were not correlated with outcomes. Surgery had no impact on the values of platelet count, plateletcrit, mean platelet volume, or platelet distribution width. Adjuvant chemotherapy significantly decreased the values of platelet count and plateletcrit, whereas it had no effect on the values of mean platelet volume or platelet distribution width. Whole course of treatment (surgery combined with adjuvant chemotherapy) significantly decreased the values of platelet count and platelet distribution width, whereas it had no effect on the values of plateletcrit or mean platelet volume. Post-/pretreatment platelet count, plateletcrit, mean platelet volume, and platelet distribution width ratios were not correlated with outcomes. Univariate analyses demonstrated that American Joint Committee on Cancer stage and pretreatment plateletcrit level were significant risk factors for prognosis. Cox regression analysis revealed that no factor independently associated with worse survival. Conclusion: Pretreatment plateletcrit level could be a potential prognostic factor in resectable lung cancers.
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Affiliation(s)
- Jing-Jing Wang
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.,2 Department of Gastroenterology, Taizhou Hospital of Traditional Chinese Medicine, Taizhou, China
| | - Yin-Ling Wang
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xin-Xin Ge
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng-Dan Xu
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Kai Chen
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Meng-Yao Wu
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei-Ran Gong
- 3 Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Min Tao
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.,4 PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, China
| | - Wen-Jie Wang
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.,5 Department of Radio-Oncology, Nanjing Medical University Affiliated Suzhou Hospital, Suzhou, China
| | - Liu-Mei Shou
- 6 Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medicine University, Hangzhou, China
| | - Wei Li
- 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.,4 PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, China.,7 Comprehensive Cancer Center, Suzhou Xiangcheng People's Hospital, Suzhou, China
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Scheiner B, Kirstein M, Popp S, Hucke F, Bota S, Rohr-Udilova N, Reiberger T, Müller C, Trauner M, Peck-Radosavljevic M, Vogel A, Sieghart W, Pinter M. Association of Platelet Count and Mean Platelet Volume with Overall Survival in Patients with Cirrhosis and Unresectable Hepatocellular Carcinoma. Liver Cancer 2019; 8:203-217. [PMID: 31192156 PMCID: PMC6547277 DOI: 10.1159/000489833] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 05/06/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Platelets have been reported to influence tumor biology and may promote metastasis. Traditionally, thrombocytopenia, a hallmark of cirrhosis, was associated with hepatocellular carcinoma (HCC) development. However, the impact of platelet count on outcome in patients with established HCC is not well studied. METHODS Outcomes of patients with cirrhosis diagnosed with HCC between 1995 and 2013 (derivation cohort) and 2000-2016 (validation cohort) who were not eligible for surgical treatment and did not receive antiplatelet therapy were retrospectively studied. Thrombocytopenia was defined as platelet count < 150 g/L. High mean platelet volume (MPV) was defined as ≥median value of the respective cohort (derivation cohort: ≥11 fL; validation cohort: ≥10.6 fL). RESULTS Among 626 patients with unresectable HCC, thrombocytopenia was present in 378 (60.4%) and was associated with favorable baseline tumor characteristics: lower diameter of the largest nodule (5.6 ± 3.2 vs. 7.6 ± 4.2 cm), less extrahepatic spread (9.5 vs. 20.2%, both p < 0.001), less macrovascular invasion (21.2 vs. 31.0%, p = 0.005), and lower BCLC stages (63.0 vs. 73.4% BCLC C/D; p = 0.007) as compared to patients with normal platelet count. On univariate analysis, thrombocytopenia and larger MPV were associated with longer overall survival (OS) (thrombocytopenia: median OS [95% CI], 11.5 [9.3-13.8] vs. 5.5 [3.8-7.1] months; p = 0.001; MPV ≥11 fL: 11.7 [9.1-14.2] vs. 6.0 [4.4-7.6] months; p < 0.001). In multivariate analysis, the combined variable of thrombocytopenia and larger MPV was independently associated with longer OS (HR [95% CI], 0.80 [0.65-0.98]; p = 0.029). These results were confirmed in an independent external validation cohort of 525 patients with cirrhosis and HCC. Again, patients with thrombocytopenia and high MPV had significantly longer OS (15.3 [11.7-18.9] vs. 9.3 [7.4-11.2] months; p < 0.001). CONCLUSIONS Thrombocytopenia and higher MPV are associated with better outcome in patients with advanced HCC. These findings may prompt further clinical research on additive antiplatelet therapy in the prevention and management of HCC.
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Affiliation(s)
- Bernhard Scheiner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria,Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria
| | - Martha Kirstein
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Sabine Popp
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Florian Hucke
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria,Department of Gastroenterology and Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
| | - Simona Bota
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria,Department of Gastroenterology and Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria
| | - Nataliya Rohr-Udilova
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria
| | - Christian Müller
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Markus Peck-Radosavljevic
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria,Department of Gastroenterology and Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria,Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria
| | - Arndt Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Wolfgang Sieghart
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria
| | - Matthias Pinter
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria,Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, Vienna, Austria,*Matthias Pinter, MD, PhD, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18–20, AT–1090 Vienna (Austria), E-Mail
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Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions. Mediators Inflamm 2019; 2019:9213074. [PMID: 31148950 PMCID: PMC6501263 DOI: 10.1155/2019/9213074] [Citation(s) in RCA: 232] [Impact Index Per Article: 46.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/26/2019] [Accepted: 02/28/2019] [Indexed: 12/14/2022] Open
Abstract
Platelet size has been demonstrated to reflect platelet activity and seems to be a useful predictive and prognostic biomarker of cardiovascular events. It is associated with a variety of prothrombotic and proinflammatory diseases. The aim is a review of literature reports concerning changes in the mean platelet volume (MPV) and its possible role as a biomarker in inflammatory processes and neoplastic diseases. PubMed database was searched for sources using the following keywords: platelet activation, platelet count, mean platelet volume and: inflammation, cancer/tumor, cardiovascular diseases, myocardial infarction, diabetes, lupus disease, rheumatoid arthritis, tuberculosis, ulcerative colitis, renal disease, pulmonary disease, influencing factors, age, gender, genetic factors, oral contraceptives, smoking, lifestyle, methods, standardization, and hematological analyzer. Preference was given to the sources which were published within the past 20 years. Increased MPV was observed in cardiovascular diseases, cerebral stroke, respiratory diseases, chronic renal failure, intestine diseases, rheumatoid diseases, diabetes, and various cancers. Decreased MPV was noted in tuberculosis during disease exacerbation, ulcerative colitis, SLE in adult, and different neoplastic diseases. The study of MPV can provide important information on the course and prognosis in many inflammatory conditions. Therefore, from the clinical point of view, it would be interesting to establish an MPV cut-off value indicating the intensity of inflammatory process, presence of the disease, increased risk of disease development, increased risk of thrombotic complications, increased risk of death, and patient's response on applied treatment. Nevertheless, this aspect of MPV evaluation allowing its use in clinical practice is limited and requires further studies.
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47
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Yang M, Pan Y, Li Z, Yan H, Zhao X, Liu L, Jing J, Meng X, Wang Y, Wang Y. Platelet Count Predicts Adverse Clinical Outcomes After Ischemic Stroke or TIA: Subgroup Analysis of CNSR II. Front Neurol 2019; 10:370. [PMID: 31031698 PMCID: PMC6473473 DOI: 10.3389/fneur.2019.00370] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 03/25/2019] [Indexed: 01/27/2023] Open
Abstract
Background: The clinical significance of platelet count (PC) for ischemic cerebrovascular disease is not well-established and further risk stratification according to baseline PC within normal range has not been reported before. We aim to evaluate the prognostic effect of baseline circulating PC within normal range on the risk of long-term recurrent stroke, mortality and functional outcomes after ischemic stroke or TIA. Methods: We derived data from eligible patients with ischemic stroke or TIA from the China National Stroke Registry (CNSR) II. Participants were divided into quintiles according to baseline PC within normal range (100–450 × 109/L). Multivariable cox regression and logistic regression were adopted to explore the correlation of baseline PC with recurrent stroke, mortality and poor functional outcomes (modified Rankin Scale 3~6) within 1-year follow-up. Results: Among the16842 eligible participants, the average age was 64.7 ± 11.9, 1,241 (7.4%) had recurrent stroke, 1,377 (8.2%) died, and 3,557 (21.1%) ended up with poor functional outcomes after 1-year follow-up. Compared with the third PC quintile (186–212 × 109/L), patients in the top quintile (249–450 × 109/L) presented with increased risk of recurrent stroke (adjusted hazard ratio 1.21, [1.02–1.45]), all-cause mortality (adjusted hazard ratio 1.43, [1.19–1.73]), and poor functional outcome (adjusted odds ratio 1.49, [1.28–1.74]), while patients in the lowest PC quintile(100–155 × 109/L) had higher risk of poor functional outcome (adjusted odds ratio 1.19, [1.02–1.38]). Conclusion: In ischemic stroke or TIA patients with platelet count within normal range, platelet count may be a qualified predictor for long-term recurrent stroke, mortality, and poor functional outcome.
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Affiliation(s)
- Ming Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yuesong Pan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Zixiao Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Hongyi Yan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Liping Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jing Jing
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Xia Meng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yilong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yongjun Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, China.,China National Clinical Research Center for Neurological Diseases, Beijing, China.,Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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Buttarello M, Mezzapelle G, Plebani M. Effect of preanalytical and analytical variables on the clinical utility of mean platelet volume. Clin Chem Lab Med 2019; 56:830-837. [PMID: 29194040 DOI: 10.1515/cclm-2017-0730] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 10/20/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The study endpoint was to analyze the effect of preanalytical (time, temperature, anticoagulant) and analytical (imprecision, correlation between volume and platelet concentration) variables on mean platelet volume (MPV). A further aim was to calculate in an adult population the reference intervals using the Sysmex XE-5000 analyzer. A critical evaluation was also made of the clinical utility of these parameters. METHODS Analyses of the above values were performed in duplicate in 170 healthy adults of both sexes: (1) within 30 min from collection, and (2) after 4 h. To evaluate stability over time, the value of the platelet parameters of 20 subjects were determined, a re-analysis being performed for a period of up to 24 h on samples maintained at room temperature and 4°C using either K2-EDTA or Na-citrate as anticoagulants. RESULTS The stability over time of MPV closely depends on the anticoagulant used, storage temperature and time interval between venipuncture and analysis. An inverse, non-linear correlation between MPV and platelet count was also found. CONCLUSIONS In view of their effect on MPV and other related indices, the preanalytical and analytical variables make them, little more than experimental.
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Affiliation(s)
- Mauro Buttarello
- Department of Laboratory Medicine, University-Hospital, Padova, Italy
| | | | - Mario Plebani
- Department of Laboratory Medicine, University-Hospital, Padova, Italy
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49
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Abeles RD, Mullish BH, Forlano R, Kimhofer T, Adler M, Tzallas A, Giannakeas N, Yee M, Mayet J, Goldin RD, Thursz MR, Manousou P. Derivation and validation of a cardiovascular risk score for prediction of major acute cardiovascular events in non-alcoholic fatty liver disease; the importance of an elevated mean platelet volume. Aliment Pharmacol Ther 2019; 49:1077-1085. [PMID: 30836450 PMCID: PMC6519040 DOI: 10.1111/apt.15192] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 10/24/2018] [Accepted: 01/23/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Atherosclerotic cardiovascular disease is a key cause of morbidity in non-alcoholic fatty liver disease (NAFLD) but appropriate means to predict major acute cardiovascular events (MACE) are lacking. AIM To design a bespoke cardiovascular risk score in NAFLD. METHODS A retrospective derivation (2008-2016, 356 patients) and a prospective validation (2016- 2017, 111 patients) NAFLD cohort study was performed. Clinical and biochemical data were recorded at enrolment and mean platelet volume (MPV), Qrisk2 and Framingham scores were recorded one year prior to MACE (Cardiovascular death, acute coronary syndrome, stroke and transient ischaemic attack). RESULTS The derivation and validation cohorts were well-matched, with MACE prevalence 12.6% and 12%, respectively. On univariate analysis, age, diabetes, advanced fibrosis, collagen proportionate area >5%, MPV and liver stiffness were associated with MACE. After multivariate analysis, age, diabetes and MPV remained independently predictive of MACE. The "NAFLD CV-risk score" was generated using binary logistic regression: 0.06*(Age) + 0.963*(MPV) + 0.26*(DM1 ) - 16.44; 1 Diabetes mellitus: 1: present; 2: absent. (AUROC 0.84). A cut-off of -3.98 gave a sensitivity 97%, specificity 27%, PPV 16%, and NPV 99%. An MPV alone of >10.05 gave a sensitivity 97%, specificity 59%, PPV 24% and NPV 97% (AUROC 0.83). Validation cohort AUROCs were comparable at 0.77 (NAFLD CV-risk) and 0.72 (MPV). In the full cohort, the NAFLD CV-risk score and MPV outperformed both Qrisk2 and Framingham scores. CONCLUSIONS The NAFLD CV risk score and MPV accurately predict 1-year risk of MACE, thereby allowing better identification of patients that require optimisation of their cardiovascular risk profile.
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Affiliation(s)
- Robin D. Abeles
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
| | - Benjamin H. Mullish
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
| | - Roberta Forlano
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
| | - Torben Kimhofer
- Department of Surgery and CancerCentre for Computational and System Medicine, Imperial College LondonLondonUK
| | - Maciej Adler
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
| | - Alexandros Tzallas
- Department of Computer Engineering, School of Applied TechnologyTechnological Educational Institute of EpirusArtaGreece
| | - Nikolaos Giannakeas
- Department of Computer Engineering, School of Applied TechnologyTechnological Educational Institute of EpirusArtaGreece
| | - Michael Yee
- Department of EndocrinologySt Mary’s Hospital, Imperial College Healthcare NHS TrustLondonUK
| | - Jamil Mayet
- National Heart and Lung Institute, Hammersmith Hospital, Imperial College LondonLondonUK
| | - Robert D. Goldin
- Department of Cellular PathologySt Mary’s Hospital, Imperial College Healthcare NHS TrustLondonUK
| | - Mark R. Thursz
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
| | - Pinelopi Manousou
- Liver Unit/ Division of Integrative Systems Medicine and Digestive Disease, Department of Surgery and CancerSt Mary’s Hospital Campus, Imperial College LondonLondonUK
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50
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Staszewski J, Pogoda A, Data K, Walczak K, Nowocień M, Frankowska E, Stępień A. The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis. Clin Interv Aging 2019; 14:493-503. [PMID: 30880930 PMCID: PMC6398411 DOI: 10.2147/cia.s195451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The role of biomarkers in the prediction of acute ischemic stroke (AIS) outcome or response to thrombolytic therapy (with recombinant tissue plasminogen activator [rt-PA]) remains limited. The aim of this study was to evaluate whether mean platelet volume (MPV) could predict short-term functional outcome in patients with AIS following rt-PA treatment. Patients and methods This was a retrospective analysis of 237 AIS patients (mean age 71.04±0.8 years, 50.6% women) consecutively admitted to a tertiary care center between 2011 and 2015. Results The mean MPV in the cohort was 9.8±0.35 fL (lowest tertile <7.29 fL, median 7.29–8.8 fL, and highest tertile >8.8 fL). Patients in the lowest tertile compared to median and highest tertiles were less often dependent (modified Rankin scale [mRS] ≥3) at admission (87.2% vs 96.1% and 96.1%, respectively, P=0.04) and less often had a poor stroke outcome (mRS 4–6) at discharge (28.2% vs 55.3% and 44.7%, P<0.01). However, there was no significant difference between tertiles with regard to AIS etiology, CT (Alberta Stroke Program Early CT) score, frequency of stroke due to large artery occlusion, risk of secondary hemorrhage, and early neurologic deterioration. Multivariable analysis after adjustment for confounders showed that patients in the second and third tertiles had a significantly higher risk of poor stroke outcome (OR =1.9, 95% CI =1.01–4), lack of early improvement (OR =1.91, 95% CI =1.05–3.47), lower chance of good outcome (mRS 0–2; OR =0.38, 95% CI =0.18–0.78), or minor stroke at discharge (OR =0.47, 95% CI =0.26–0.84). Receiver operating characteristic analysis for prediction of poor stroke outcome showed that the optimal cut-off point of MPV was 8.8 fL (area under the curve 0.586 [0.512–0.659], P=0.03) with a sensitivity of 82.7% and a specificity of 43.9%. Conclusion Disabling or fatal ischemic stroke in thrombolyzed patients was observed more often in patients with high admission MPV. The prognostic value of MPV was independent of other well-defined individual risk factors.
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Affiliation(s)
- Jacek Staszewski
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Aleksandra Pogoda
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Kamila Data
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Klaudia Walczak
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
| | - Maciej Nowocień
- Department of Radiology, Military Institute of Medicine, Warsaw, Poland
| | - Emilia Frankowska
- Department of Radiology, Military Institute of Medicine, Warsaw, Poland
| | - Adam Stępień
- Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland,
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