Association Of Platelet Count Research Articles

Association of Platelet Count with Severity of COVID-19 Infection at the Time of Admission in Pakistan: A Retrospective Study

Objective: To determine the association of platelet count with the severity of COVID-19 infection. Study Design: Retrospective longitudinal study. Place and Duration of Study: Mayo Hospital, Lahore Pakistan, from Aug 2020 and Aug 2021. Methodology: Data was recorded in a proforma. The severity of COVID-19 infection, based on physical examination and saturation measured on a pulse oximeter recorded at the time of presentation to the hospital, was noted. A platelet count was obtained from a complete blood count at the presentation time. Platelet counts were compared in patients with non-severe infection and severe infection. Results: The mean age of the patients was 50.11±14.20 years. Out of 200 patients, 134(67%) were male and 66(33%) were female. Sixty-three (31.5%) patients had non-severe, while 137(68.5%) had severe COVID-19 symptoms. A significant association was seen between the severity of illness and platelet count at the time of presentation, with a p-value of 0.047. Conclusion: This study shows that in COVID-19 patients, thrombocytopenia at the time of presentation to the hospital is associated with severe disease.

Non-genetic biomarkers for ankylosing spondylitis: An umbrella review.

The objective of the study was to provide an overview of the existing evidence on non-genetic biomarkers for ankylosing spondylitis (AS). In this umbrella review, we searched PubMed and Web of Science from database inception to October 31, 2020. Systematic reviews and meta-analyses of observational studies investigating the associations between any non-genetic biomarkers and AS were included. We estimated summary standardized mean difference (SMD) along with 95% confidence interval (CI), I2 statistic, 95% prediction interval (PI), and assessed small-study effects and excess significance bias. The study was registered in PROSPERO with registration number of CRD42020218240. A total of 1276 publications were identified, of which 21 articles covering 43 non-genetic biomarkers were eligible for inclusion. Evidence of 22 (51%) non-genetic biomarkers exhibited a nominally significant effect (p < 0.05) on AS, and 7 associations (14%) showed small-study effects. The associations of platelet count (SMD: 0.53, 95% CI: 0.36 to 0.71) and serum interleukin (IL)-23 levels (SMD = 2.03, 95% CI: 1.27 to 2.79) with AS presented highly suggestive evidence, while circulating IL-17 levels (SMD = 2.36, 95% CI: 1.71, 3.01) and Treg/PBMC ratio (SMD = -0.75, 95% CI: -1.06 to -0.44) presented suggestive evidence. However, these associations showed large or very large between-study heterogeneity, suggesting an indefinite direction for the effect when 95% PIs were considered. No convincing evidence supported the existence of a non-genetic biomarker for AS. Some highly suggestive associations might be affected by bias, therefore, promising non-genetic biomarkers for AS remain limited at least based on the current evidence from observational studies.

Association of platelet count with mortality in patients with infectious diseases in intensive care unit: a multicenter retrospective cohort study

Platelets play important roles in thrombosis, hemostasis, inflammation, and infection. We aimed to evaluate the association between platelet count and its variation trend and prognosis of patient with infectious diseases in intensive care units (ICUs). This retrospective cohort study extracted 4,251 critically ill adult patients with infectious diseases from the eICU Collaborative Research Database, whose platelet counts were measured daily during the first 7 days after admission. In the survivors, platelet counts decreased in the first days after admission, reached a nadir on day 3, and then returned and continued to rise above the admission value. In non-survivors, the platelet counts decreased after admission, without a subsequent upturn. We defined three subgroups according to the nadir platelet counts within 7 days: ≤50, 50–130, and ≥130 × 109/L, corresponding to high, intermediate, and low ICU mortality. A decreased platelet count was associated with increased ICU mortality (intermediate vs. low: 1.676 [1.285–2.187]; high vs. low: 3.632 [2.611–5.052]). In conclusion, during the first 7 days, platelet counts decreased after ICU admission, while increased subsequently in the survivors but not in the non-survivors. ICU mortality risk increased as nadir platelet count decreased below 130 × 109/L, and further boosted when it reached below 50 × 109/L.

Association of platelet count with all-cause mortality from acute respiratory distress syndrome: A cohort study.

BackgroundThe purpose of this study was to investigate whether platelet count was associated with mortality in acute respiratory distress syndrome (ARDS) patients.MethodsWe analyzed patients with ARDS from Multi‐parameter Intelligent Monitoring in Intensive Care Database III (MIMIC‐III). Platelet count was measured at the time of intensive care unit (ICU) admission. The cox proportional hazard model and subgroup analysis were used to determine the relationship between the platelet count and mortality of ARDS, as well as the consistency of its association. The primary outcome of this study was 365‐day mortality from the date of ICU admission.ResultThis study enrolled a total of 395 critically ill patients with ARDS. After adjustment for age, gender and ethnicity, the multivariate cox regression model showed that the hazard ratios (HRs) (95% confidence intervals [CIs]) of platelet count <192 × 109/L and >296 × 109/L were 2.08 (1.43, 3.04) and 1.35 (0.91, 2.01), respectively, compared with the reference (192–296 ×109/L). After adjusting for confounding factors, lower platelet count (<192 × 109/L) was associated with increased mortality (adjusted HR, 1.71; 95% CI 1.06–2.76, p = 0.0284). However, there was no similar trend in the 30‐day (adjusted HR,1.02; 95% CI 0.54–1.94) or 90‐day (adjusted HR, 1.65; 95% CI 0.94–2.89) mortality. In the subgroup analysis, lower platelet count showed significant interactions with specific populations (p interaction = 0.0413), especially in patients with atrial fibrillation.ConclusionTaken together, our analysis showed that platelet count is an independent predictor of mortality in critically ill patients with ARDS.

A Study of Correlation Between Dengue Serological Markers and Platelet Count in Ajmer Region

Background: Dengue is an acute viral infection has emerged as a notable public health problem. Rapid immunochromatographic test and IgM/IgG ELISA has been the mainstay of diagnosis. Combination of NS1 antigen detection along with antibody detection increases the diagnostic rates. Thrombocytopenia begins during febrile phase. Therefore, we tried to evaluate the association of platelet counts against immunochromatographic test (NS1 and IgM/IgG) and IgM ELISA in dengue infections.&#x0D; Methodology: The study of variation in different platelet parameters in dengue fever cases was undertaken in our department over a period of 18 months from July 2017 to December 2018. Inclusion criteria: All patients with clinical features and serologically positive dengue infection included. &#x0D; Exclusion criteria: Patient’s which are serologically negative dengue and if routine laboratory test suggesting a bacterial, parasite or any viral infection other than dengue infection or any other disease. &#x0D; CBC was done from all clinically suspected dengue cases. Serum samples were tested for NS1, IgM and IgG by immunochromatography-based test and IgM MAC-Capture ELISA. Platelet counts were obtained from all serologically positive cases. Test results of dengue specific parameters were compared against platelet counts.&#x0D; Results: Of 636 samples tested, 396 were positive for one or more dengue parameters. Of the 396, 312 were positive for NS1, 152 were positive for IgM, 41 were positive for IgG and 354 were positive for IgM ELISA. Thrombocytopenia was consistently associated with one of the serological parameters.&#x0D; Conclusion: It can be concluded from our study that Thrombocytopenia was found in all serological positive dengue cases and showed a significant correlation with serological markers.

Association of platelet count and plateletcrit with nerve conduction function and peripheral neuropathy in patients with type2 diabetes mellitus.

Aims/IntroductionDiabetes has been considered as a ‘pro‐thrombotic state’ with enhanced platelet reactivity. Abnormality in platelet aggregation has been found in patients with its most common chronic complication – diabetic peripheral neuropathy (DPN). The purpose of this study was to investigate the potential association of platelet indices with nerve conduction function and the presence of DPN in Chinese patients with type 2 diabetes mellitus.Materials and MethodsThis study involved a total of 211 inpatients with type 2 diabetes mellitus and 55 healthy individuals for whom nerve conduction studies were carried out. DPN was diagnosed according to the American Diabetes Association recommendation. Clinical data were retrospectively collected.ResultsPatients with diabetes in whom neuropathy developed had lower levels of platelet count (PLT) and plateletcrit (PCT) than healthy controls (P < 0.05). Statistically significant associations of low PLT and PCT levels with the reduction of summed amplitude/velocity Z‐score, and the prolongation of F‐wave minimum latency in nerve conduction studies were found. Furthermore, after multivariate adjustment, logistic regression analysis showed that low levels of PLT (odds ratio 2.268, 95% confidence interval 1.072–4.797; P < 0.05; PLT <226 vs PLT ≥226) and PCT (odds ratio 2.050, 95% confidence interval 1.001–4.201; P < 0.05; PCT <0.222 vs PCT ≥0.222) in type 2 diabetes mellitus patients were risk factors for the presence of DPN.ConclusionsLower PLT and PCT levels are closely associated with poorer peripheral nerve conduction functions and the presence of neuropathy in patients with type 2 diabetes mellitus, which suggests that PLT and PCT might be potential biomarkers for showing DPN.

Decreased Platelet Counts and Serum Levels of VEGF-A, PDGF-BB, and BDNF in Extremely Preterm Infants Developing Severe ROP

Introduction: Thrombocytopenia has been identified as an independent risk factor for retinopathy of prematurity (ROP), although underlying mechanisms are unknown. In this study, the association of platelet count and serum platelet-derived factors with ROP was investigated. Methods: Data for 78 infants born at gestational age (GA) <28 weeks were included. Infants were classified as having no/mild ROP or severe ROP. Serum levels of vascular endothelial growth factor A, platelet-derived growth factor BB, and brain-derived neurotrophic factor were measured in serum samples collected from birth until postmenstrual age (PMA) 40 weeks. Platelet counts were obtained from samples taken for clinical indication. Results: Postnatal platelet counts and serum concentrations of the 3 growth factors followed the same postnatal pattern, with lower levels in infants developing severe ROP at PMA 32 and 36 weeks (p < 0.05–0.001). With adjustment for GA, low platelet counts and low serum concentrations of all 3 factors at PMA 32 weeks were significantly associated with severe ROP. Serum concentrations of all 3 factors also strongly correlated with platelet count (p < 0.001). Conclusion: In this article, we show that ROP, platelet counts, and specific pro-angiogenic factors correlate. These data suggest that platelet-released factors might be involved in the regulation of retinal and systemic angiogenesis after extremely preterm birth. Further investigations are needed.

Trend of Dengue Virus Infection with Seasonal Variation at HIMS, Varanasi, Uttar Pradesh, India

Introduction: Dengue is the most common mosquito borne arboviral infection in India, and it has become endemic in India with consistent episodes. Dengue is an acute febrile illness caused by Dengue Virus (DENV-1, DENV-2, DENV-3, DENV-4), an arthropod of family Flaviviridae, transmitted through the bite of female Aedes aegypti mosquitoes. Although, dengue is more prevalent in humans but also it may sometimes be seen in monkeys. The only animals to be affected when bitten by a mosquito, infected with dengue fever are monkeys other animals do not carry or spread dengue. Patient presents with hyperthermia, headache, severe joint and muscle pain, fatigue and skin rashes. Neurological manifestation in sever dengue results from multiorgan dysfunction due to cerebral edema, haemorrhage due to vascular leak, cerebral hypoperfusion, and electrolyte disturbances. Aim: To study serological markers with association of platelet count and trend of DENV infection with seasonal variation. Materials and Methods: The present retrospective study was conducted for a period of two years in Heritage Institute of Medical Sciences (HIMS), Varanasi, Uttar Pradesh, India, from January 2017 to December 2018. Blood samples were collected for 2140 suspected dengue patients. Out of the serologically positive cases, serological confirmation and platelet count was done for dengue infection. Data was presented as percentages. Results: Total 2140 suspected cases were admitted and out of them 199 (9.3%) were found to be seropositive for dengue infection. Non structural protein 1 (NS1) positive cases out of which total seropositive cases were reported to be 127 (63.81%) and 147 (73.86%) cases were positive for NS1 antigen either alone or along with antibody. Out of the total 199 positive cases thrombocytopenia was observed in 126 (63.31%) cases. Positive cases which were under 15 years of age were reported to be 92 (46.23%). Conclusion: The study concludes that NS1 antigen and IgM- IgG antibody consideration in the diagnosis of dengue infection builds the opportunity of early diagnosis so as to keep away the complications significantly.

Associations of Platelet Count with Inflammation and Response to Anti-TNF-α Therapy in Patients with Ankylosing Spondylitis.

Background: Increased platelet count has been reported in ankylosing spondylitis (AS) patients, but its clinical significance is still largely elusive. The objective of this study was to evaluate the clinical role of platelet count in AS patients, especially its impact on treatment outcomes. Methods: A case-control study containing 35 AS patients receiving anti-tumor necrosis factor-α (anti-TNF-α) therapy and 45 healthy controls was performed, and AS patients were followed at least 6 months after anti-TNF-α therapy. A systematic review and meta-analysis of studies containing relevant data on outcomes of interest was also performed. Results: AS patients had significantly higher platelet count than controls (p = 0.0001), and the significantly increased platelet count in AS patients was confirmed in a meta-analysis of 14 studies involving 1,223 AS patients and 913 controls (mean difference = 39.61, 95% CI 27.89–51.34, p < 0.001). Besides, platelet count was significantly correlated with ESR (p < 0.001) and was moderately correlated with ASDAS-CRP score (p = 0.002). Moreover, anti-TNF-α therapy could reduce platelet count in AS patients at the first month and the effect was maintained through the treatment duration. In the prospective follow-up study of those 35 AS patients, those responders to anti-TNF-α therapy had significantly lower platelet count than nonresponders (p = 0.015). Logistic regression analysis suggested that lower platelet count was associated with higher possibility of achieving good response to anti-TNF-α therapy in AS patients (odds ratio = 2.26; 95% CI = 1.06–4.82; p = 0.035). Conclusion: This study suggested that platelet count was associated with inflammation severity and treatment outcomes in AS patients, and elevated platelet count was a promising biomarker of poorer response to anti-TNF-α therapy. The findings above need to be validated in more future studies.

Pre-transplant thrombocytopenia predicts engraftment time and blood products requirement in allogeneic hematopoietic stem cell transplantation patients

IntroductionThrombocytopenia is a common consequence of leukemia that affects the outcome of hematopoietic stem cell transplantation (HSCT). The stromal damage of bone marrow following pre-HSCT conditioning regimens can delay the hematopoietic engraftment and increased blood product transfusions. We tried to define threshold based on pre-transplant platelet count as a biomarker to predict engraftment time and blood product requirements in allogeneic HSCT patients. MethodsThis retrospective study was performed on 194 patients who received allogeneic HSCT. The median for platelet (PLT) count of patients at the admission day was considered as a cut off value. The association of platelet count with white blood cell (WBC) and PLT engraftment time and also the requirement of packed red blood cell or PLT transfusions as outcomes of interest were investigated. Results164 patients (84.5 %) had successful WBC engraftment, and PLT engraftment was seen in 155 patients (79.9 %) in 30 and 50 days after HSCT, respectively. The patients with PLT count higher than 154,000/μL had better PLT engraftment (P = 0.060), and WBC engraftment (P = 0.014) than those with PLT count lower than this cut off. The pre-transplant PLT count had negative relations with SD platelet requests after HSCT (P = 0.008). ConclusionThe thrombocytopenia before HSCT might delay the platelet and WBC engraftment time, which should be taken into account before transplantation. Since the blood product transfusion is one of the factors associated with engraftment, the pre-transplant platelet count can be used as a predictive biomarker to manage the blood product requirement during the HSCT until engraftment occurs.

Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study

Background Thrombocytopenia has been implicated in patients infected with severe acute respiratory syndrome coronavirus 2, while the association of platelet count and changes with subsequent mortality remains unclear. Methods The clinical and laboratory data of 383 patients with the definite outcome by March 1, 2020 in the Central Hospital of Wuhan were reviewed. The association between platelet parameters and mortality risk was estimated by utilizing Cox proportional hazard regression models. Results Among the 383 patients, 334 (87.2%) were discharged and survived, and 49 (12.8%) died. Thrombocytopenia at admission was associated with mortality of almost three times as high as that for those without thrombocytopenia (P < 0.05). Cox regression analyses revealed that platelet count was an independent risk factor associated with in-hospital mortality in a dose-dependent manner. An increment of per 50 × 109/L in platelets was associated with a 40% decrease in mortality (hazard ratio: 0.60, 95%CI: 0.43, 0.84). Dynamic changes of platelets were also closely related to death during hospitalization. Conclusions Baseline platelet levels and changes were associated with subsequent mortality. Monitoring platelets during hospitalization may be important in the prognosis of patients with coronavirus disease in 2019.

Association of platelet count and platelet indices with cranial meningioma

Introduction and Objectives: In this study, we aimed to investigate whether platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values can be used as diagnostic markers in cranial meningiomas.&#x0D; Materials and Methods: The study included results of 29 patient and 47 healthy contributors. Based on pathologies, the patients were divided into two groups. The first group included meningioma patients and the second one included healthy individuals. Healthy contributors named control group. Platelet count and platelet indices were determined using Sysmex XN 550 haematology analyzer. The preoperative platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values were recorded from the routine laboratory tests.&#x0D; Results: There was no statistically significant difference in PLT between the meningioma and healthy groups (p = 0.217). There was a statistically significant difference in PCT between the meningioma group and the healthy group (p = 0.002). There was a statistically significant difference in PDW between meningioma group and healthy group (p = 0.001). In terms of MPV, there was a statistically significant difference between meningioma group and the healthy group (p = 0.001)&#x0D; Conclusion: Platelet count and indices are easily available in the routine blood tests. Despite the retrospective design and small sample size, our findings suggest that altered MPV, PDW and PCT levels might serve as potential biomarkers for the diagnosis of meningiomas.

Joint Multilevel Model for Analyzing Length of Stay through Competing Endpoints in Dengue Epidemiology

Dengue is a common mosquito-borne tropical disease caused by a virus. It is a life threatening disease since it sometimes leads to death within a short period of time. Multilevel modeling is a form of statistical modeling when data is at different levels. Due to dengue seriousness and risk being more similar for patients within districts than between districts, there is correlation between patients within districts. Thus district has to be taken as a cluster variable. A frequently encountered response in epidemiological studies is the length of Stay (LOS) of a patient, which measures the time until the event of interest occurs. Complexity arises with the different states/destinations of the time event and competing risk modelling is a more appropriate method for handling such states. The association of platelet count and length of stay of a dengue patient leads to the joint modelling approach for analyzing the dengue patients. Formulation criteria for the joint model with clustered data is to link these models through two sub models that is by using the multilevel multinomial logistic model for the LOS of dengue patients with different destinations and multilevel continuous model for the log platelet count. The linkage between two responses was derived by sharing a common random effect. Factors that have an effect on different destinations of LOS are, time indicators, year, age, classification, rainfall, temperature and humidity, while age, sex, classification, year place treated, rainfall, temp and humidity are associated factors for the log platelet count of dengue patients. Moreover, supremacy of joint modelling was proved by the AIC and BIC values over two separate univariate models.

The association of platelet counts with development and treatment for retinopathy of prematurity - is thrombocytopenia a risk factor?

IntroductionThrombocytes may regulate the activity of vascular endothelial growth factor (VEGF), limiting neovascularization in retinopathy of prematurity (ROP). The aim of this study was to examine the role of platelet counts, thrombocytopenia, and infections in the pathogenesis of ROP.Material and methodsThe study included 163 preterm infants diagnosed with ROP, comparing 76 patients who required treatment with 87 patients in whom ROP resolved spontaneously (control group). Further analysis concerned 52 patients in whom a first line treatment was sufficient to stop ROP progression, and 24 patients who required re-treatment.ResultsA statistically significant difference was found in the occurrence of thrombocytopenia (p = 0.015), platelet counts before the diagnosis of ROP (p = 0.008), and the presence of late-onset infection (p = 0.007). The ROC curve analysis showed that the value of platelets above 232 × 109/l may stimulate spontaneous resolution of ROP. A significant difference between patients once treated and patients that required re-treatment was found in platelet count before the diagnosis of ROP (p = 0.017), platelet count before the first intervention (p = 0.013), and the number of transfusions (p = 0.042).ConclusionsThe results of the study confirm the association between ROP development and its severity with thrombocytopenia. While there were no differences in the occurrence of thrombocytopenia right after the birth, its episode before the diagnosis of ROP seems to be significant for ROP development. The deficiency of platelets prior to a treatment intervention may be associated with necessity of re-treatment.

Association of platelet count with all-cause mortality and risk of cardiovascular and respiratory morbidity in stable COPD

BackgroundPlatelet count is a prognostic indicator in the general population and elderly. Thrombocytosis during acute exacerbation of COPD (AECOPD) has been associated with mortality; however, the relationship between platelet count and mortality in stable COPD is unknown.MethodsWe performed post hoc secondary analysis on a subsample of 1797 patients in the Study to Understand Mortality and Morbidity in COPD (SUMMIT) who had blood samples drawn at baseline. Participants were current or former smokers, 40–80 years old with moderate COPD and history or increased risk of cardiovascular (CV) disease. The primary outcome was on and post-treatment all-cause mortality. Secondary outcomes included first-on-treatment moderate/severe AECOPD and on-treatment CV composite event (CV death, myocardial infarction, stroke, unstable angina and transient ischemic attack). Multivariable Cox proportional hazards models were used to investigate study endpoint associations with platelet count quintile grouping, continuous platelet count utilizing two-term fractional polynomials, and categories of low, normal and high platelet count (< 150, ≥150 to < 300, ≥300 × 109/L).ResultsPatients were followed for 2.3 ± 0.9 years for vital status and 1.6 ± 1.1 years for morbidity endpoints during which 105 (5.8%) died, 651 (36.2%) experienced AECOPD (159 with severe AECOPD) and 86 (4.8%) experienced a CV event. A U-shaped association between platelet count and all-cause mortality was observed. Compared to the third quintile group (Q3) of platelet count, risk of death was increased in the lowest quintile group (Q1; hazard ratio [HR]: 1.73; 95% confidence interval [CI]: 0.93–3.23) and highest quintile group (Q5; HR: 1.66; 95%CI: 0.89–3.10), though point estimates were imprecise. Using clinical cutoffs, compared with normal platelet counts (≥150 to < 300 × 109/L), risk of all-cause mortality was nominally increased among patients with thrombocytopenia (HR: 1.46; 95%CI: 0.81–2.64) and high platelet count (HR: 1.66; 95%CI: 0.96–2.86). Compared with Q3, CV events were nominally increased for Q5 (HR: 1.71; 95%CI: 0.83–3.49) and Q1 (HR: 1.41; 95%CI: 0.70, 2.85). There was no association between platelet count and AECOPD.ConclusionsIn stable COPD platelet count demonstrated a U-shaped association with increased risk of 3-year all-cause mortality, though a platelet count level above or below which risk of mortality was increased could not be definitively identified.Trial registrationClinicalTrials.gov NCT01313676.

Association of Platelet Count and Mean Platelet Volume with Overall Survival in Patients with Cirrhosis and Unresectable Hepatocellular Carcinoma

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.

Association of Platelet Count and Platelet Transfusion With Serotonin Level During Living Donor Liver Transplantation: Possible Connection to Graft Regeneration

BackgroundWe recently showed that platelet counts and the amount of platelet transfusion during liver transplantation are positively associated with early graft regeneration. It was hypothesized that platelet-derived serotonin mediates liver regeneration. ObjectivesThis study aimed to evaluate the association between intraoperative platelet count, platelet transfusion, and serum serotonin level. MethodsThirty-two recipients undergoing living-donor liver transplantation were enrolled into this prospective observational study. Serum platelet counts and serotonin levels were measured at the following times: anesthetic induction, start of the anhepatic phase, before graft reperfusion, 5 minutes/1 hour/3 hours/5 hours after graft reperfusion, and before/after platelet transfusion. Serotonin was measured by using a liquid chromatography tandem mass spectrometry. ResultsSerotonin level at the anesthetic induction was 24.5 μg/mL (interquartile range, 14.6 to 38.1 μg/mL). During surgery, serial changes in platelet counts and serotonin levels showed a similar trend: they decreased during the anhepatic phase, increased during the first hour after graft reperfusion, and thereafter gradually decreased. Serotonin level was positively correlated with platelet counts (correlation coefficient = 0.620, P < .001). Allogeneic platelet transfusion significantly increased platelet count from 22 (19–31) × 109/L to 53 (50–81) × 109/L (P = .008) and it also increased serum serotonin from 11.04 (6.41–15.34) μg/mL to 34.26 (25.86–41.94) μg/mL (P = .008). ConclusionsOur findings indicate that allogeneic platelets could act as effector cells deriving serotonins. Also, our findings support the hypothesis that the association between platelets and post-transplantation graft regeneration is mediated by serotonin. Further studies are warranted regarding the respective role of serotonin and other platelet-derived molecules mediating liver regeneration.

Association of Platelet Count and Platelet Indices with Stages of Women Breast Cancer in Yola, Nigeria

Association of Platelet Count and Platelet Indices with Stages of Women Breast Cancer in Yola, Nigeria

Association of platelet count, fibrosis-4, and aspartate aminotransferase-to-platelet ratio index with the development and severity of esophageal varices in patients with liver cirrhosis

Association of platelet count, fibrosis-4, and aspartate aminotransferase-to-platelet ratio index with the development and severity of esophageal varices in patients with liver cirrhosis

Association of platelet count with sarcopenic obesity in postmenopausal women: A nationwide population-based study

ObjectivesThe aim of this study was to examine the relationship between platelet count and sarcopenic obesity in postmenopausal women. MethodThis cross-sectional study was conducted using nationally representative data. A total of 2810 postmenopausal women who participated in the 2008–2011 Korea National Health and Nutrition Examination Survey were included in this study. Sarcopenic obesity was defined by a sarcopenia criterion and an obesity criterion. Platelet counts were divided into quartiles as follows: Q, 150–222; Q2, 223–257; Q3, 258–294, and Q4, 295–450 (103/μl). Multiple logistic regression analysis was performed to examine the association between platelet count quartile and sarcopenic obesity after adjusting for confounding factors. ResultsThe prevalence of sarcopenic obesity in postmenopausal women was 14.8%. Compared to the lowest platelet quartile, the odds ratios and 95% confidence intervals for sarcopenic obesity in the highest quartile were 1.98 (1.36–2.89) in the unadjusted model; 1.93 (1.31–2.83) after adjusting for age; and 1.65 (1.23–2.65) after adjusting for age, systolic blood pressure, homeostatic model assessment insulin resistance (HOMA-IR), triglyceride, total cholesterol, total calorie intake, regular exercise, current smoking status, and education level. ConclusionsElevated platelet count (i.e. towards the upper end of the normal range) was significantly associated with sarcopenic obesity in postmenopausal women.