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Journal of Clinical Medicine Jul 2023The measurement and identification of plasma biomarkers can support the estimation of risk and diagnosis of deep vein thrombosis (DVT) associated with the use of a... (Review)
Review
BACKGROUND
The measurement and identification of plasma biomarkers can support the estimation of risk and diagnosis of deep vein thrombosis (DVT) associated with the use of a peripherally inserted central catheter (PICC).
OBJECTIVES
This systematic review and meta-analysis aimed to identify the association between the levels of potential biomarkers that reflect the activation of the blood system, long-term vascular complications, inflammatory system, and the occurrence of PICC-related DVT.
METHODS
Seven electronic databases (Embase, Web of Science, Medline, Scopus, Cinahl, Cochrane Central Register of Controlled Trials, and ERIC) were searched to identify literature published until December 2022. Studies were required to report: (I) adult and pediatric patients, outpatient or admitted to clinical, surgical, or ICU with PICC; (II) patients with PICC-related DVT and patients without PICC-related DVT as a comparator; and (III) at least one biomarker available. The Newcastle-Ottawa Scale was used to evaluate the quality of the studies. Study precision was evaluated by using a funnel plot for platelets level. We provided a narrative synthesis and meta-analysis of the findings on the biomarkers' outcomes of the studies. We pooled the results using random effects meta-analysis. The meta-analysis was conducted using Review Manager software v5.4. This systematic review is registered in PROSPERO (CRD42018108871).
RESULTS
Of the 3564 studies identified (after duplication removal), 28 were included. PICC-related DVT was associated with higher D-dimers (0.37 μg/mL, 95% CI 0.02, 0.72; = 0.04, I = 92%; for heterogeneity < 0.00001) and with higher platelets (8.76 × 10/L, 95% CI 1.62, 15.91; = 0.02, I = 41%; for heterogeneity = 0.06).
CONCLUSIONS
High levels of D-dimer and platelet were associated with DVT in patients with PICC. However, biomarkers such as APTT, fibrinogen, FDP, glucose, hemoglobin, glycated hemoglobin, INR, prothrombin time, prothrombin fragment 1.2, the thrombin-antithrombin complex, and WBC were not related to the development of DVT associated with PICC.
PubMed: 37445515
DOI: 10.3390/jcm12134480 -
Current Pharmaceutical Design 2017Platelet endothelial aggregation receptor 1 (PEAR1) may affect platelet-platelet contact and aggregation. The aim of this study was to assess the association between... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Platelet endothelial aggregation receptor 1 (PEAR1) may affect platelet-platelet contact and aggregation. The aim of this study was to assess the association between PEAR1 polymorphisms and risks of platelet aggregation.
METHODS
We searched the PubMed, EmBase, and Cochrane Library electronic databases for articles published through November 30th. 2016. Meta-analysis was performed to examine the relationship between PEAR1 and platelet aggregation and sensitivity analysis by removing individual study from meta-analysis. We collected and analyzed the results of 5 trials involving 5466 patients.
RESULTS
Our results demonstrated that the G allele of rs12041331 was associated with a greater platelet aggregation by multiple agonists, both in the presence and absence of antiplatelet drugs, in several separate cohorts of different ethnicities along with an apparent allelic dose-response effect. However, the results of studies on rs2768759 locus were inconsistent and further studies are required. In the presence or absence of antiplatelet drugs treatment, the lowest platelet aggregation was observed in rs2768759 wild-type (AA) patients, followed by heterozygous (AC) and homozygous mutant (CC).
CONCLUSION
PEAR1 rs12041331 is associated with platelet function and antiplatelet drug pharmacodynamics. Future studies on relationship between single nucleotide polymorphisms of PEAR1 and incidence of cardiovascular diseases are required.
Topics: Genetic Variation; Humans; Platelet Aggregation; Platelet Aggregation Inhibitors; Platelet Function Tests; Receptors, Cell Surface
PubMed: 28820077
DOI: 10.2174/1381612823666170817122043 -
Panminerva Medica Mar 2023The recent Sars-CoV-2 pandemic (COVID-19) has led to growing research to explain the poor clinical prognosis in some patients. While early observational studies...
INTRODUCTION
The recent Sars-CoV-2 pandemic (COVID-19) has led to growing research to explain the poor clinical prognosis in some patients. While early observational studies highlighted the role of the virus in lung failure, in a second moment thrombosis emerged as a possible explanation of the worse clinical course in some patients. Despite initial difficulties in management of such patients, the constant increase of literature in the field is to date clarifying some questions from clinicians. However, several other questions need answer.
EVIDENCE ACQUISITION
We performed systematic research using Embase and PubMed, inserting the keywords and mesh terms relative to the new coronavirus and to VTE: "COVID-19," "SARS," "MERS," "coronavirus," "2019 n-CoV," venous thromboembolism," "pulmonary embolism," "deep vein thrombosis," "thromboembolism," "thrombosis." Boolean operators "AND," "OR," "NOT" were used where appropriate. We found 133 articles of interest but only 20 were selected, providing the most representative information.
EVIDENCE SYNTHESIS
A novel disease (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2) infection was responsible for thousands of hospitalizations for severe acute respiratory syndrome, with several cases of thrombotic complications due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis. COVID-19 and hospitalizations for COVID-19 may carry several potential risk factors for thrombosis. Severe coagulation abnormalities may occur in almost all the severe and critical ill COVID-19 cases.
CONCLUSIONS
Despite a strong pathophysiological rationale, the evidence in literature is not enough to recommend an aggressive antithrombotic therapy in COVID-19. However, it is our opinion that an early use, even at home at the beginning of the disease, could improve the clinical course.
Topics: Humans; Anticoagulants; COVID-19; Disease Progression; SARS-CoV-2; Thrombosis; Venous Thromboembolism
PubMed: 32549531
DOI: 10.23736/S0031-0808.20.03999-3 -
Current Atherosclerosis Reports Dec 2011Coronary heart disease (CHD) is the leading cause of death in the United States. The high content of polyphenols and flavonoids present in cocoa has been reported to... (Review)
Review
Coronary heart disease (CHD) is the leading cause of death in the United States. The high content of polyphenols and flavonoids present in cocoa has been reported to play an important protective role in the development of CHD. Although studies have demonstrated beneficial effects of chocolate on endothelial function, blood pressure, serum lipids, insulin resistance, and platelet function, it is unclear whether chocolate consumption influences the risk of CHD. This article reviews current evidence on the effects of cocoa/chocolate on clinical and subclinical CHD, CHD risk factors, and potential biologic mechanisms. It also discusses major limitations of currently available data and future directions in the field.
Topics: Cacao; Coronary Circulation; Coronary Disease; Endothelium, Vascular; Flavonols; Humans; Inflammation Mediators; Insulin Resistance; Lipids; Platelet Aggregation; Risk Factors
PubMed: 21894553
DOI: 10.1007/s11883-011-0203-2 -
Current Pharmaceutical Design 2018Platelet hyperactivity has been implicated in many cardiovascular (CV) events such as ischemic stroke, myocardial infarction and CV death. Genetic variability of...
BACKGROUND
Platelet hyperactivity has been implicated in many cardiovascular (CV) events such as ischemic stroke, myocardial infarction and CV death. Genetic variability of platelet receptors has been shown to impact Src family kinases (SFKs) activation and in turn influence platelet activation. SFKs are important signal transmitters in platelets, interacting with several receptors as GPIIB/IIIa, GPIb, PEAR 1, GPIa, GPVI, PECAM and CD148.
METHODS
In this review, we focused on genetic variants of platelet receptors whose signals are transmitted mainly by SFKs and may be associated with clinical manifestations of platelet hyperactivation like MI or IS.
RESULTS
The genetic variants of platelet receptors, the signals of which are transmitted by SFKs, and the associated clinical manifestations in platelet hyperactivation, have been examined. The most extensively studied receptors were glycoprotein polymorphisms. The greatest numbers of genetic variants were analyzed in GPIb. GPIIb/IIIa receptor polymorphisms were also well analyzed and many studies highlighted their associations with ischemic stroke (IS) and myocardial infarction (MI). However, there are a number of conflicting studies finding that GPIIb/IIIa receptor polymorphisms may not influence platelet hyperactivity. Moreover, variability within some other receptors like GPVI, PECAM, PEAR1, and CD148 was analyzed only in single studies.
CONCLUSIONS
Src family kinases are one of the most important signal transmitters in platelets. Some receptors have well documented interactions with SFKs, while other have not been examined in humans or data about its association originated from single studies. Further studies are necessary to confirm the findings and reduce falsepositive associations.
Topics: Genetic Variation; Humans; Platelet Activation; Platelet Glycoprotein GPIIb-IIIa Complex; Polymorphism, Genetic; src-Family Kinases
PubMed: 29237371
DOI: 10.2174/1381612824666171213105002 -
International Journal of Impotence... Dec 2022Erectile dysfunction (ED) is a global health problem that commonly occurs due to multiple factors, particularly by a vascular abnormality with the activation of platelet... (Meta-Analysis)
Meta-Analysis Review
Erectile dysfunction (ED) is a global health problem that commonly occurs due to multiple factors, particularly by a vascular abnormality with the activation of platelet (PLT). Mean platelet volume (MPV), a PLT activity marker, has been hypothesized to be associated with ED. The present meta-analysis aims to evaluate the MPV and its contribution to ED diagnosis. A systematic searching to summarize the association of MPV as a predictive marker for ED was conducted on two databases, including MEDLINE (PubMed) and CINAHL (EBSCOhost). We included all English studies that measured MPV levels in ED and non-ED subjects. A total of 168 publications were initially retrieved and screened systematically. 12 studies with 1643 subjects were included for both qualitative and quantitative analysis. The MPV mean difference between ED patients and healthy subjects; vasculogenic and non-vasculogenic ED showed significant differences. Our findings show PLT is associated with the development of ED. Higher MPV level was found in the ED subjects compared to the healthy controls. Nevertheless, the evidence is still limited due to the small number of studies and further investigations are required to support the utilization of MPV for ED diagnosis.
Topics: Humans; Male; Blood Platelets; Erectile Dysfunction; Mean Platelet Volume; Platelet Count
PubMed: 35091698
DOI: 10.1038/s41443-021-00523-7 -
The Canadian Journal of Cardiology Nov 2016Platelet microparticles (PMP), shedding on platelet activation, have been proposed as key components in the procoagulant and proinflammatory process. The aim of this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Platelet microparticles (PMP), shedding on platelet activation, have been proposed as key components in the procoagulant and proinflammatory process. The aim of this study was to clarify the correlation between plasma PMP concentration and the presence of acute coronary syndrome (ACS).
METHODS
We searched for potential relevant studies in PubMed, EMBASE, the Cochrane Library, and Web of Science databases before December 2015. After screening for eligibility, 11 observational studies that tested the plasma concentration of PMP in patients with ACS were retrieved for comprehensive review, quality assessment, and data extraction.
RESULTS
Seven studies (64%) provided explicit information between healthy controls and patients with ACS. Five studies (45%) addressed the plasma levels of PMP between patients with ACS and patients with stable angina. Moreover, 5 studies (45%) compared changes in PMP concentration before and after percutaneous coronary intervention (PCI) in patients with ACS. The results showed a significant difference in plasma PMP levels between the patients with ACS and healthy controls, with the pooled standardized mean difference of 1.95 (95% confidence intervals, 0.87-3.02; P < 0.0001). And the plasma concentration of PMP in patients with ACS was higher before PCI than after PCI (standardized mean difference, -0.97; 95% confidence interval, -1.91 to -0.03; P = 0.043). Four of the five studies described that patients with ACS had higher plasma PMP concentration than patients with stable angina, but there was no significant difference between these 2 patient cohorts.
CONCLUSIONS
PMP is a promising biomarker for the development of ACS. Moreover, PCI, the most common treatment for ACS, could effectively decrease the plasma concentration of PMP, indicating PMP as a prognostic factor.
Topics: Acute Coronary Syndrome; Biomarkers; Blood Platelets; Cell-Derived Microparticles; Humans; Prognosis
PubMed: 27177836
DOI: 10.1016/j.cjca.2016.02.052 -
Iranian Journal of Medical Sciences Nov 2022Platelet aggregation is a crucial mechanism in the progression of atherothrombotic events. This systematic review aims to introduce the plants studied in healthy people... (Review)
Review
BACKGROUND
Platelet aggregation is a crucial mechanism in the progression of atherothrombotic events. This systematic review aims to introduce the plants studied in healthy people as the primary prevention to inhibit platelet aggregation. We also discuss possible mechanisms that are involved in the inhibition of platelet aggregation.
METHODS
A systematic search on the electronic medical databases from 1970 to February 2020 was performed. The selected keywords were: "herb", "plant", "platelet aggregation", "platelet activation", "clinical trial", "randomized" and "controlled".
RESULTS
The result of the initial search was a pool of 136 articles. After initial abstract reviewing, there were 55 relevant articles. Finally, 28 eligible records fulfilled our inclusion criteria to enter the qualitative synthesis process.
CONCLUSION
Out of the 10 plants evaluated in the clinical trials, nine had inhibitory effects on platelet aggregation. Most of the reviewed plants, including tomato ( L), garlic (), kiwifruit (), cacao (), grape (), ginkgo (), flaxseed (), sea buckthorn berry (), and argan () could be potential sources for the primary prevention of atherothrombotic events at an appropriate dosage. Finally, we do not consider phytoceuticals as a replacement for the guideline-directed medical treatment. Large randomized double-blind clinical trials are required to evaluate the anti-platelet characteristics of these plants for the adjuvant primary prevention of cardiovascular disease.
Topics: Humans; Platelet Aggregation Inhibitors; Randomized Controlled Trials as Topic; Platelet Aggregation; Ginkgo biloba; Garlic; Hippophae; Primary Prevention
PubMed: 36380973
DOI: 10.30476/IJMS.2021.91328.2247 -
International Journal of Cardiology Sep 2013ADP-specific platelet function assays were shown to predict thrombotic events, and might be helpful to select candidates for more potent antiplatelet therapy. We aimed... (Meta-Analysis)
Meta-Analysis Review
Efficacy and safety of intensified antiplatelet therapy on the basis of platelet reactivity testing in patients after percutaneous coronary intervention: systematic review and meta-analysis.
BACKGROUND
ADP-specific platelet function assays were shown to predict thrombotic events, and might be helpful to select candidates for more potent antiplatelet therapy. We aimed to determine the efficacy and safety of giving intensified antiplatelet therapy on the basis of platelet reactivity testing for patients undergoing percutaneous coronary intervention (PCI).
METHODS
Electronic databases were searched to find prospective, randomized trials that reported the clinical impact of using an intensified antiplatelet protocol (repeated loading or elevated maintenance doses of clopidogrel, prasugrel or glycoprotein IIb/IIIa inhibitor) on the basis of ADP-specific platelet reactivity testing (VerifyNow, Multiplate, VASP or light transmission aggregometry) compared to standard-dose clopidogrel. Evaluated efficacy measures included cardiovascular death, non-fatal myocardial infarction and definite/probable stent thrombosis (ST), while major bleeding events were recorded as safety endpoint.
RESULTS
Between 2008 and 2011, 10 clinical trials comprising 4213 randomized patients were identified. Compared to standard antiplatelet therapy, the intensified protocol was associated with a significant reduction in cardiovascular mortality, ST and myocardial infarction (p<0.01 for all). There was no difference in the rate of major bleeding events between intensified and standard groups (p=0.44). Although the observed effects regarding mortality, ST and bleeding were not heterogeneous, meta-regression analysis revealed that the net clinical benefit of the intensified treatment significantly depended on the risk of ST with standard-dose clopidogrel (p=0.023).
CONCLUSION
Intensifying antiplatelet therapy on the basis of platelet reactivity testing reduces cardiovascular mortality and ST after PCI; however, the net benefit of this approach depends on the risk of ST with standard-dose clopidogrel.
Topics: Humans; Percutaneous Coronary Intervention; Platelet Activation; Platelet Aggregation Inhibitors; Platelet Function Tests; Randomized Controlled Trials as Topic; Thrombosis; Treatment Outcome
PubMed: 22704866
DOI: 10.1016/j.ijcard.2012.05.100 -
PloS One 2017Antipsychotic (AP) safety has been widely investigated. However, mechanisms underlying AP-associated pneumonia are not well-defined. (Review)
Review
INTRODUCTION
Antipsychotic (AP) safety has been widely investigated. However, mechanisms underlying AP-associated pneumonia are not well-defined.
AIM
The aim of this study was to investigate the known mechanisms of AP-associated pneumonia through a systematic literature review, confirm these mechanisms using an independent data source on drug targets and attempt to identify novel AP drug targets potentially linked to pneumonia.
METHODS
A search was conducted in Medline and Web of Science to identify studies exploring the association between pneumonia and antipsychotic use, from which information on hypothesized mechanism of action was extracted. All studies had to be in English and had to concern AP use as an intervention in persons of any age and for any indication, provided that the outcome was pneumonia. Information on the study design, population, exposure, outcome, risk estimate and mechanism of action was tabulated. Public repositories of pharmacology and drug safety data were used to identify the receptor binding profile and AP safety events. Cytoscape was then used to map biological pathways that could link AP targets and off-targets to pneumonia.
RESULTS
The literature search yielded 200 articles; 41 were included in the review. Thirty studies reported a hypothesized mechanism of action, most commonly activation/inhibition of cholinergic, histaminergic and dopaminergic receptors. In vitro pharmacology data confirmed receptor affinities identified in the literature review. Two targets, thromboxane A2 receptor (TBXA2R) and platelet activating factor receptor (PTAFR) were found to be novel AP target receptors potentially associated with pneumonia. Biological pathways constructed using Cytoscape identified plausible biological links potentially leading to pneumonia downstream of TBXA2R and PTAFR.
CONCLUSION
Innovative approaches for biological substantiation of drug-adverse event associations may strengthen evidence on drug safety profiles and help to tailor pharmacological therapies to patient risk factors.
Topics: Antipsychotic Agents; Computational Biology; Genetic Predisposition to Disease; Humans; Pneumonia
PubMed: 29077727
DOI: 10.1371/journal.pone.0187034