1
|
Hernáez Á, Lassale C, Castro-Barquero S, Ros E, Tresserra-Rimbau A, Castañer O, Pintó X, Vázquez-Ruiz Z, Sorlí JV, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Sacanella E, Razquin C, Corella D, Guasch-Ferré M, Cofán M, Estruch R. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients 2021; 13:559. [PMID: 33567733 PMCID: PMC7915168 DOI: 10.3390/nu13020559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022] Open
Abstract
There is little information on the dietary modulation of thrombosis-related risk factors such as platelet count. We aimed to assess the effects of Mediterranean diet (MedDiet) on platelet count and related outcomes in an older population at high cardiovascular risk. In participants of the PREDIMED (PREvención con DIeta MEDiterránea) study, we assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, modulated platelet count (n = 4189), the risk of developing thrombocytosis and thrombocytopenia (n = 3086), and the association between these alterations and all-cause mortality (median follow-up time: 3.0 years). Although platelet count increased over time (+0.98·109 units/L·year [95% confidence interval: 0.12; 1.84]), MedDiet interventions moderated this increase, particularly in individuals with near-high baseline count (both MedDiets combined: -3.20·109 units/L·year [-5.81; -0.59]). Thrombocytopenia incidence was lower in the MedDiet interventions (incidence rates: 2.23% in control diet, 0.91% in MedDiets combined; hazard ratio: 0.44 [0.23; 0.83]). Finally, thrombocytopenia was associated with a higher risk of all-cause mortality (hazard ratio: 4.71 [2.69; 8.24]), but this relationship was attenuated in those allocated to MedDiet (p-interaction = 0.018). In brief, MedDiet maintained platelet counts within a healthy range and attenuated platelet-related mortality in older adults at high cardiovascular risk.
Collapse
Affiliation(s)
- Álvaro Hernáez
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Sara Castro-Barquero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
| | - Emilio Ros
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Zenaida Vázquez-Ruiz
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
| | - José V. Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain;
| | - Ángel M. Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain
| | - Emilio Sacanella
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Cristina Razquin
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Marta Guasch-Ferré
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Montserrat Cofán
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Ramón Estruch
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| |
Collapse
|
8
|
Christenson JT, Gras PA, Grosclaude A, Simonet F, Schmuziger M. Reactive thrombocytosis following coronary artery bypass surgery: a possible link to a lipid dysfunction. J Cardiovasc Surg (Torino) 1996; 37:491-8. [PMID: 8941691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Reactive thrombocytosis (RT, Platelet counts >400x10(3)/mm3) following coronary artery bypass grafting (CABG) has earlier been described to occur frequently (20%) and is associated with thrombotic complications eg. vein graft occlusion. This prospective study was undertaken in an attempt to identify the underlaying causes of RT following CABG. Fourty consecutive patients undergoing elective CABG entered the study, between December 1, 1994 and April 15, 1995. Patient characteristics, operation data, cardiopulmonary data and postoperative complications (30 parameters) were entered into a database together with routine blood chemistry and hematology results, hemostasis and antiinflammatory (eg.IL-6) parameter (25 parameters/day), preoperatively until the 9th postoperative day. Fifteen patients developed RT and the remaining 25 served as controls (C). Fourteen patients, chosen at random, received Aspirin, 100 mg daily, starting from the 3rd postoperative day, all patients were anticoagulated postoperatively with heparin and later coumarine. Patient characteristics, except a larger number of patients with hyperlipidemia in the RT group, did not differ. Operation data, cardiopulmonary bypass data as well as postoperative complications revealed no group differences, neither did preoperative laborations, except that S-Cholesterol was higher in the RT-group, 6.2+/-0.9 vs 5.3+/-0.9, p<0.018. All blood laborations were without group differences throughout the entire study period, except platelet counts, platelet size (PWD) and mean platelet volume (MPV), and AT III levels at the 7th postoperative day, which was significantly lower in controls compared to RT. RT patients had a less marked drop in platelet count immediately after cardiopulmonary bypass than non-RT together with an increased MPV, but without differences in the PWD. There was a significantly higher platelet count in the RT-group on the 3rd postoperative day, which remained higher throughout the study period and RT was established on the 7th postoperative day. Additional treatment with Aspirin postoperatively did not influence studied parameters. This study has again found RT frequently occurring after CABG (30%). It was found that the preoperative S-Cholesterol level was significantly higher in the RT group, while hemostasis and anti-inflammatory parameters did not differ RT vs non-RT. It could therefore be possible that RT is linked to a lipid dysfunction and further studies are on-going.
Collapse
Affiliation(s)
- J T Christenson
- Cardiovascular Surgery Unit, Hôpital de la Tour, Meyrin-Geneva, Switzerland
| | | | | | | | | |
Collapse
|