-
Journal of Clinical Gastroenterology Jan 2016Nonalcoholic fatty liver disease (NAFLD) is linked to obesity, metabolic syndrome, and cardiovascular disease. Increased mean platelet volume (MPV), a marker of platelet... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Nonalcoholic fatty liver disease (NAFLD) is linked to obesity, metabolic syndrome, and cardiovascular disease. Increased mean platelet volume (MPV), a marker of platelet activity, is associated with acute myocardial infarction, stroke, thrombosis, and increased mortality after myocardial infarction. The purpose of this study was to perform a meta-analysis to investigate the relationship between NAFLD and MPV.
METHODOLOGY
A systematic search of MEDLINE (Ovid), PubMed, and CINAHL databases from 1950 to May 2014, complemented with manual review of references of published articles for studies comparing MPV in patients with and without NAFLD was done. Results were pooled using both fixed and random effects model.
RESULTS
Our analysis from pooling of data from 8 observational studies including 1428 subjects (NAFLD=842 and non-NAFLD=586) showed that MPV was significantly higher in patients with NAFLD than those without. The standardized mean difference in MPV between NAFLD and controls was 0.457 (95% confidence interval: 0.348-0.565, P<0.001) using fixed and 0.612 (95% confidence interval: 0.286-0.938, P<0.001) using random effects model.
CONCLUSIONS
This study suggests that MPV is significantly higher in patients with NAFLD, indicating the presence of increased platelet activity in such patients. Future research is needed to investigate whether this increased MPV is associated with increased cardiovascular disease in patients with NAFLD.
Topics: Blood Platelets; Cardiovascular Diseases; Humans; Mean Platelet Volume; Metabolic Syndrome; Non-alcoholic Fatty Liver Disease; Obesity
PubMed: 25984978
DOI: 10.1097/MCG.0000000000000340 -
Expert Review of Clinical Immunology Nov 2022Severe manifestations of coronavirus disease 2019 (COVID-19) are associated with alterations in blood cells that regulate immunity, inflammation, and hemostasis. We... (Meta-Analysis)
Meta-Analysis
A systematic review and meta-analysis of the association between the neutrophil, lymphocyte, and platelet count, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio and COVID-19 progression and mortality.
BACKGROUND AND AIMS
Severe manifestations of coronavirus disease 2019 (COVID-19) are associated with alterations in blood cells that regulate immunity, inflammation, and hemostasis. We conducted an updated systematic review and meta-analysis of the association between the neutrophil, lymphocyte, and platelet count, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), and COVID-19 progression and mortality.
METHODS
A systematic literature search was conducted in PubMed, Web of Science, and Scopus for studies published between January 2020 and June 2022.
RESULTS
In 71 studies reporting the investigated parameters within 48 hours of admission, higher NLR (HR 1.21, 95% CI 1.16 to 1.27, p < 0.0001), relative neutrophilia (HR 1.62, 95% CI 1.46 to 1.80, p < 0.0001), relative lymphopenia (HR 1.62, 95% CI 1.27 to 2.08, p < 0.001), and relative thrombocytopenia (HR 1.74, 95% CI 1.36 to 2.22, p < 0.001), but not PLR (p = 0.11), were significantly associated with disease progression and mortality. Between-study heterogeneity was large-to-extreme. The magnitude and direction of the effect size were not modified in sensitivity analysis.
CONCLUSIONS
NLR and neutrophil, lymphocyte, and platelet count significantly discriminate COVID-19 patients with different progression and survival outcomes. (PROSPERO registration number: CRD42021267875).
Topics: Humans; Platelet Count; Neutrophils; Lymphocyte Count; COVID-19; Prognosis; Lymphocytes; Blood Platelets; Retrospective Studies
PubMed: 36047369
DOI: 10.1080/1744666X.2022.2120472 -
Cellular Physiology and Biochemistry :... 2017Systemic inflammatory response (SIR) is widely considered as a preoperative risk factor for hepatocellular carcinoma (HCC) outcomes. The neutrophil to lymphocyte ratio... (Meta-Analysis)
Meta-Analysis Review
Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio as Prognostic Predictors for Hepatocellular Carcinoma Patients with Various Treatments: a Meta-Analysis and Systematic Review.
BACKGROUND/AIMS
Systemic inflammatory response (SIR) is widely considered as a preoperative risk factor for hepatocellular carcinoma (HCC) outcomes. The neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), two of the prognostic indices, have been investigated in post-therapeutic recurrence and survival of HCC. Here, we quantify the prognostic value of these two biomarkers and evaluate their consistency in different HCC therapies.
METHODS
A systematic review of electronic database of the Web of Science, Embase, PubMed and the Cochrane Library was conducted to search for associations between the NLR and PLR in the blood and clinical outcomes of HCC. Overall survival (OS) and recurrence-free survival (RFS) were the primary outcomes, and hazard ratios (HRs) and 95% confidence intervals (95% CIs) were explored as effect measures. Subgroup analyses were performed to explore the heterogeneity of different therapies.
RESULTS
A total of 24 articles comprising 6318 patients were included in the meta-analysis. Overall, the pooled outcomes revealed that a high NLR before treatment predicted a poor OS (HR: 1.54, 95% CI: 1.34 to 1.76, p<0.001) and poor RFS (HR: 1.45, 95% CI: 1.16 to 1.82, p=0.001). Moreover, an increased PLR predicted a poor OS (HR: 1.63, 95% CI: 1.34 to 1.98, p<0.001) and earlier HCC recurrence (HR: 1.52, 95% CI: 1.21 to 1.91, p<0.001). In addition, both the NLR and PLR were identified as independent risk factors for predicting OS and RFS in HCC patients in a subgroup analysis of different treatment types, including curative or palliative therapy; however, these results were not found in the sorafenib subgroup due to limited clinical research.
CONCLUSION
An increased NLR or PLR indicated poor outcomes for patients with HCC. The NLR and PLR may be considered as reliable and inexpensive biomarkers for making clinical decisions regarding HCC treatment.
Topics: Antineoplastic Agents; Blood Platelets; Carcinoma, Hepatocellular; Databases, Factual; Humans; Liver Neoplasms; Lymphocytes; Neoplasm Recurrence, Local; Neutrophils; Prognosis; Proportional Hazards Models; Survival Rate
PubMed: 29179180
DOI: 10.1159/000485396 -
European Journal of Oral Implantology 2014Autologous platelet concentrates are claimed to enhance hard and soft tissue healing due to the considerable amount of growth factors that are released after application... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Autologous platelet concentrates are claimed to enhance hard and soft tissue healing due to the considerable amount of growth factors that are released after application in the surgical site. However, their actual efficacy for improving tissue healing and regeneration in oral surgery applications is controversial. Tooth extraction socket healing represents a proper model to study the effect of autologous platelet-enriched preparations due to the concomitant occurrence of different processes of both hard and soft tissue healing.
PURPOSE
To evaluate the efficacy of platelet concentrates for alveolar socket healing after tooth extraction, by conducting a systematic review.
MATERIALS AND METHODS
Medline, Embase and Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. The last electronic search was performed on 15 June, 2014. Manual searching of the relevant journals and of the reference lists of reviews and all identified randomised controlled trials was also performed. Randomised controlled trials evaluating the effect of a platelet concentrate on fresh extraction sockets were included. Further inclusion criteria were that at least 10 patients were treated (at least 5 per group) and there was a minimum follow-up duration of 3 months. Primary outcomes were postoperative complications, patient satisfaction and postoperative discomfort. Secondary outcomes were any clinical, radiographic, histological and histomorphometric variables used to assess hard and soft tissue healing. Assessment of the methodological quality of the trials was made. RESULTS were expressed as fixed-effects models using mean differences for continuous outcomes and risk ratios for dichotomous outcomes, with 95% confidence intervals (CI).
RESULTS
The initial search yielded 476 articles. After the screening process, six articles met the inclusion criteria (199 teeth in 156 patients). Three studies were considered at high risk of bias, two at medium risk and one at low risk. A large heterogeneity in study characteristics and outcome variables used to assess hard tissue healing was observed. A meta-analyses of two studies reporting histomorphometric evaluation of bone biopsies at 3 months' follow-up showed greater bone formation when platelet concentrates were used, as compared to control cases (P <0.001; mean difference 20.41%, 95% C.I. 13.29%, 27.52%). Beneficial effects of platelet concentrates were generally but not systematically reported in most studies, in particular when considering the effects on soft tissue healing and the patient's reported postoperative symptoms like pain and swelling, although no meta-analysis could be done for such parameters.
CONCLUSIONS
Although the results of the meta-analysis of the present review are suggestive for a positive effect of platelet concentrates on bone formation in post-extraction sockets, due to the limited amount and quality of the available evidence, they need to be cautiously interpreted. A standardisation of the experimental design is necessary for a better understanding of the true effects of the use of platelet concentrates for enhancing post-extraction socket healing.
Topics: Blood Platelets; Blood Transfusion, Autologous; Fibrin; Humans; Intercellular Signaling Peptides and Proteins; Osteogenesis; Platelet Transfusion; Platelet-Rich Plasma; Randomized Controlled Trials as Topic; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 25422822
DOI: No ID Found -
Thrombosis and Haemostasis Feb 2022Patients with cardiovascular disease (CVD) are at increased risk of suffering myocardial infarction. Platelets are key players in thrombus formation and, therefore,...
Patients with cardiovascular disease (CVD) are at increased risk of suffering myocardial infarction. Platelets are key players in thrombus formation and, therefore, antiplatelet therapy is crucial in the treatment and prevention of CVD. MicroRNAs (miRs) may hold the potential as biomarkers for platelet function and maturity. This systematic review was conducted using the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). To identify studies investigating the association between miRs and platelet function and maturity in patients with CVD, PubMed and Embase were searched on October 13 and December 13, 2020 without time boundaries. Risk of bias was evaluated using a standardized quality assessment tool. Of the 16 included studies, 6 studies were rated "good" and 10 studies were rated "fair." In total, 45 miRs correlated significantly with platelet function or maturity (rho ranging from -0.68 to 0.38, all < 0.05) or differed significantly between patients with high platelet reactivity and patients with low platelet reactivity (-values ranging from 0.0001 to 0.05). Only four miRs were investigated in more than two studies, namely miR-223, miR-126, miR-21 and miR-150. Only one study reported on the association between miRs and platelet maturity. In conclusion, a total of 45 miRs were associated with platelet function or maturity in patients with CVD, with miR-223 and miR-126 being the most frequently investigated. However, the majority of the miRs were only investigated in one study. More data are needed on the potential use of miRs as biomarkers for platelet function and maturity in CVD patients.
Topics: Biomarkers; Blood Platelets; Cardiovascular Diseases; Cell Differentiation; Humans; MicroRNAs
PubMed: 34091883
DOI: 10.1055/s-0041-1730375 -
European Review For Medical and... Nov 2021The current study aimed to conduct a systematic literature search and pool data from individual studies to assess the relationship between platelet-lymphocyte ratio... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The current study aimed to conduct a systematic literature search and pool data from individual studies to assess the relationship between platelet-lymphocyte ratio (PLR) and functional outcomes and mortality in stroke patients.
MATERIALS AND METHODS
The databases of PubMed, Embase and Google Scholar were searched for relevant studies up to 21st August 2021. Odds ratios (OR) with 95% confidence intervals (CI) were calculated for the association between PLR and poor functional outcomes and mortality.
RESULTS
Sixteen studies were included in the systematic review and nine in the meta-analysis. On analysis of eight studies, we noted no statistically significant relationship between PLR and poor functional outcomes in patients with stroke (OR: 1.00 95% CI: 1.00, 1.00 I2=80% p=0.30). Data on mortality was reported by just two studies. Pooled analysis indicated no statistical relationship between PLR and mortality in patients with stroke (OR: 1.49 95% CI: 0.56, 3.98 I2=76% p=0.43). Descriptive analysis of the remaining studies demonstrated conflicting results for the relationship between PLR and early neurological deterioration (END) and functional outcomes.
CONCLUSIONS
Our results indicate that PLR may not be a useful prognostic marker to predict functional outcomes after AIS. Evidence on the predictive power of PLR for mortality and END after stroke is scarce and contrasting. There is a need for further studies assessing the role of PLR in predicting outcomes of stroke patients while taking into account important confounders like baseline stroke severity and treatment modality.
Topics: Biomarkers; Blood Platelets; Humans; Ischemic Stroke; Lymphocyte Count; Lymphocytes; Platelet Count; Prognosis
PubMed: 34787855
DOI: 10.26355/eurrev_202111_27095 -
Platelets 2015The majority of patients with ischaemic cerebrovascular disease (CVD) are not protected from further vascular events with antiplatelet therapy. Measurement of inhibition... (Meta-Analysis)
Meta-Analysis Review
The majority of patients with ischaemic cerebrovascular disease (CVD) are not protected from further vascular events with antiplatelet therapy. Measurement of inhibition of platelet function ex vivo on antiplatelet therapy, using laboratory tests that correlate with the clinical effectiveness of these agents, would potentially enable physicians to tailor antiplatelet therapy to suit individuals. A systematic review of the literature was performed to collate all available data on ex vivo platelet function/reactivity in CVD patients, especially those treated with aspirin, dipyridamole or clopidogrel. Particular emphasis was paid to information from commonly available whole blood platelet function analysers (PFA-100®, VerifyNow® and Multiplate®). Data on pharmacogenetic mechanisms potentially influencing high on-treatment platelet reactivity (HTPR) on antiplatelet therapy in CVD were reviewed. Two-hundred forty-nine potentially relevant articles were identified; 93 manuscripts met criteria for inclusion. The prevalence of ex vivo HTPR in CVD varies between 3-62% with aspirin monotherapy, 8-61% with clopidogrel monotherapy and 56-59% when dipyridamole is added to aspirin in the early, subacute or late phases after TIA/stroke onset. The prevalence of HTPR on aspirin was higher on the PFA-100 than on the VerifyNow in one study (p < 0.001). Furthermore, the prevalence of HTPR on aspirin was lower when one used 'novel longitudinal' rather than 'cross-sectional, case-control' definitions of HTPR on the PFA early after TIA or stroke (p = 0.003; 1 study). Studies assessing the influence of genetic polymorphisms on HTPR in CVD patients are limited, and need validation in large multicentre studies. Available data illustrate that an important proportion of CVD patients have ex vivo HTPR on their prescribed antiplatelet regimen, and that the prevalence varies depending on the definition and assay used. Large, adequately-sized, prospective multicentre collaborative studies are urgently needed to determine whether comprehensive assessment of HTPR at high and low shear stress with a range of user-friendly whole blood platelet function testing platforms, in conjunction with pharmacogenetic data, improves our ability to predict the risk of recurrent vascular events in CVD patients, and thus enhance secondary prevention following TIA or ischaemic stroke.
Topics: Animals; Blood Platelets; Humans; Ischemic Attack, Transient; Platelet Aggregation Inhibitors; Platelet Function Tests; Prevalence; Stroke
PubMed: 26042726
DOI: 10.3109/09537104.2015.1049139 -
Vox Sanguinis May 2017Prolonged storage improves availability of platelet products but could also influence safety and efficacy. This systematic review and meta-analyses summarize and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Prolonged storage improves availability of platelet products but could also influence safety and efficacy. This systematic review and meta-analyses summarize and quantify the evidence of the effect of storage time of transfused platelets on clinical outcomes.
METHODS
A systematic search in seven databases was performed up to February 2016. All studies reporting storage time of platelet products and clinical outcomes were included. To quantify heterogeneity, I² was calculated, and to assess publication bias, funnel plots were constructed.
RESULTS
Twenty-three studies reported safety outcomes and fifteen efficacy outcomes. The relative risk of a transfusion reaction after old platelets compared to fresh platelets was 1·53 (95% confidence interval (CI): 1·04-2·25) (12 studies). This was 2·05 (CI:1·47-2·85) before and 1·05 (CI: 0·60-1·84) after implementation of universal leucoreduction. The relative risk of bleeding was 1·13 (CI: 0·97-1·32) for old platelets compared to fresh (five studies). The transfusion interval was 0·25 days (CI: 0·13; 0·38) shorter after transfusion of old platelets (four studies). Three studies reported use of platelet products: two for haematological patients and one for trauma patients. Selecting only studies in haematological patients, the difference was 4·51 units (CI: 1·92; 7·11).
CONCLUSION
Old platelets increase the risk of transfusion reactions in the setting of non-leucoreduction, shorten platelet transfusion intervals, thereby increase the numbers of platelet transfusions in haematological patients, and may increase the risk of bleeding.
Topics: Hemorrhage; Humans; Platelet Transfusion; Thrombocytopenia; Treatment Outcome
PubMed: 28271517
DOI: 10.1111/vox.12494 -
BMJ Open Dec 2023To summarise evidence on the effectiveness of Platelet-Rich Plasma (PRP) gel and Leucocyte and Platelet Rich Fibrin (L-PRF) gel as agents promoting ulcer healing...
OBJECTIVE
To summarise evidence on the effectiveness of Platelet-Rich Plasma (PRP) gel and Leucocyte and Platelet Rich Fibrin (L-PRF) gel as agents promoting ulcer healing compared with the standard wound dressing techniques alone.
DESIGN
Systematic review.
ELIGIBILITY CRITERIA
Individual patient randomised controlled trials on skin ulcers of all types excluding traumatic lesions.Intervention group: treatment with topical application of L-PRF gel or PRP gel to the wound surface.
CONTROL GROUP
treatment with standard skin ulcer care using normal saline, normgel or hydrogel dressings.
INFORMATION SOURCES
Medline (Ovid), Excerpta Medica Database (EMBASE), Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Web of Science and manual search of studies from previous systematic reviews and meta-analyses. The papers published from 1946 to 2022 with no restriction on geography and language were included. The last date of the search was performed on 29 August 2022.
DATA EXTRACTION AND SYNTHESIS
Independent reviewers identified eligible studies, extracted data, assessed risk of bias using V.2 of the Cochrane risk-of-bias tool for randomised trials tool and assessed certainty of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
MAIN OUTCOME MEASURES
Time to complete healing, proportion healed at a given time and rate of healing.
RESULTS
Seven studies met the inclusion criteria, five using PRP gel and two using L-PRF gel. One study showed a better proportion of complete healing, three reported reduced meantime to complete healing and five showed improved rate of healing per unit of time in the intervention group. The risk of bias was high across all studies with one exception and the GRADE showed very low certainty of evidence.
CONCLUSION
The findings show potential for better outcomes in the intervention; however, the evidence remains inconclusive highlighting a large research gap in ulcer treatment and warrant better-designed clinical trials.
PROSPERO REGISTRATION NUMBER
CRD42022352418.
Topics: Humans; Fibrin; Platelet-Rich Fibrin; Platelet-Rich Plasma; Ulcer; Skin Ulcer
PubMed: 38086583
DOI: 10.1136/bmjopen-2023-073209 -
International Journal of Stroke :... Aug 2013An important proportion of transient ischemic attack or ischemic stroke is attributable to moderate or severe (50-99%) atherosclerotic carotid stenosis or occlusion.... (Review)
Review
An important proportion of transient ischemic attack or ischemic stroke is attributable to moderate or severe (50-99%) atherosclerotic carotid stenosis or occlusion. Platelet biomarkers have the potential to improve our understanding of the pathogenesis of vascular events in this patient population. A detailed systematic review was performed to collate all available data on ex vivo platelet activation and platelet function/reactivity in patients with carotid stenosis. Two hundred thirteen potentially relevant articles were initially identified; 26 manuscripts met criteria for inclusion in this systematic review. There was no consistent evidence of clinically informative data from urinary or soluble blood markers of platelet activation in patients with symptomatic moderate or severe carotid stenosis who might be considered suitable for carotid intervention. Data from flow cytometry studies revealed evidence of excessive platelet activation in patients in the early, sub-acute, or late phases after transient ischemic attack or stroke in association with moderate or severe carotid stenosis and in asymptomatic moderate or severe carotid stenosis compared with controls. Furthermore, pilot data suggest that platelet activation may be increased in recently symptomatic than in asymptomatic severe carotid stenosis. Excessive platelet activation and platelet hyperreactivity may play a role in the pathogenesis of first or subsequent transient ischemic attack or stroke in patients with moderate or severe carotid stenosis. Larger longitudinal studies assessing platelet activation status with flow cytometry and platelet function/reactivity in symptomatic vs. asymptomatic carotid stenosis are warranted to improve our understanding of the mechanisms responsible for transient ischemic attack or stroke.
Topics: Animals; Carotid Artery Diseases; Carotid Stenosis; Humans; Platelet Activation
PubMed: 23013536
DOI: 10.1111/j.1747-4949.2012.00866.x