Indicator Of Platelet Activation Research Articles

The Relationship Between Mean Platelet Volume and Fasting Plasma Glucose and HbA1c Levels in a Large Cohort of Unselected Health Check-Up Participants

BackgroundLarger platelets are more active and mean platelet volume (MPV) is an indicator of platelet activation and an independent risk factor of cardiovascular diseases. While MPV is reported to be higher in diabetic patients, the relationship between MPV and glycemic parameters in general population remains inconclusive.MethodsIn this cross-sectional study, we studied relationship between MPV and fasting plasma glucose (FPG) and HbA1c levels in 38,204 unselected participants of general health check-up aged 20 years or older in the year of 2014 who were considered to be representative of the general population. Individuals with known diabetes, coronary artery disease and/or cerebrovascular disease who were on drug therapy and those with platelet counts below 100 × 109/L or above 400 × 109/L were excluded.ResultsThe mean age of the individuals was 52.3 ± 12.1 years and 46.1% were male. There were positive associations between MPV and both FPG (r = 0.066; P < 0.001) and HbA1c (r = 0.025; P < 0.001) levels when all individuals were analyzed as a whole. While the association was only marginal in individuals with HbA1c levels below 6.5% (r = 0.009; P = 0.068), it was significant in those with HbA1c ≥ 6.5% (r = 0.138; P < 0.001). When the individuals were categorized into four groups according to the HbA1c values: HbA1c < 5.5%, 5.5% ≤ HbA1c < 6.0%, 6.0% ≤ HbA1c < 6.5%, and HbA1c ≥ 6.5%, the mean MPV was virtually same among groups with HbA1c level < 6.5% and that of the individuals with HbA1c ≥ 6.5 was significantly higher than groups with lower HbA1c levels. Multivariate analyses adjusted with age and sex showed the same results.ConclusionFPG and HbA1c appeared to be associated with MPV in unselected health check-up participants; however, the association between glycemic state and MPV was apparent only in individuals with impaired glycemic control and only marginal in those with normal glycemic control. The clinical significance of the associations warrants further study.

The relationship between platelet volume and risk of atherosclerosis in patients with psoriasis

Objective The aim of this research was to evaluate the relation between the mean platelet volume (MPV) and clinical aspects (onset, duration, and severity) in patients with psoriasis. In addition, the purpose was to evaluate the possible risk of atherosclerosis in these patients. Background Psoriasis is an inflammatory skin disease affecting 2–4% of the world population. However, studies in developing countries have reported higher prevalence rates of ∼4.6% on an average. MPV is an indicator of platelet activation, and it is a newly emerging risk factor for patients with atherothrombotic psoriasis. Patients and methods A case–control study was conducted on 40 patients with variable degrees of psoriasis severity (cases) and they were compared with 20 matched healthy participants (controls). All participants were selected from dermatology inpatients and outpatient clinics of the Menoufia University Hospital in the period from September 2015 to March 2016. Full detailed history, routine laboratory investigations, clinical features, Psoriasis Area and the Severity Index (PASI) scores, and carotid intima-media thickness (CIMT) and nonalcoholic fatty liver disease (NAFLD) values were taken for each participant (cases and controls). Results There were statistically no significant differences between patients with psoriasis and control groups regarding age, sex, BMI, total cholesterol, and triglycerides (P>0.05%, for all), whereas patients with psoriasis had significantly higher systolic and diastolic blood pressure, fasting plasma glucose, mean MPV and CIMT values, and frequency of ultrasound-diagnosed NAFLD than the control group. In addition, BMI, duration of illness, PASI, and mean values of MPV were significantly (P=0.5) elevated in patients with psoriasis with atherosclerosis than patients with psoriasis without atherosclerosis. Moreover, MPV level was correlated positively with age, BMI, duration of psoriasis, PASI score, and CIMT in the atherosclerotic psoriatic case group. Moreover, CIMT and PASI score were correlated positively with BMI, duration of illness, MPV, systolic blood pressure, diastolic blood pressure, glycated hemoglobin, and NAFLD in the psoriasis patient group, whereas CIMT was significantly correlated positively with PASI score. Conclusion Psoriasis is associated with high MPV. So, MPV is a good indicator of psoriasis severity. Thus, MPV is a good positive test for early detection of premature atherosclerosis in patients with psoriasis. This study may confirm previous observation indicating increased platelet activation in psoriasis. Increased platelet activity could contribute toward increasing the atherosclerotic risk in patients with psoriasis.

Platelet microRNA for predicting acute myocardial infarction.

Acute myocardial infarction (AMI) is one of the leading causes of morbidity and mortality worldwide, while early diagnosis still represents an upmost priority. While platelet activation is critical for AMI pathogenesis, the role of platelet microRNAs (pmiRNAs) as biomarkers for AMI is unclear. Furthermore, correlations between the levels of pmiRNAs and indices of platelet activity are also unknown. Expression of platelet miR-1, miR-21, miR-126, miR-150 and miR-223 were prospectively assessed in 20 ST-segment elevation myocardial infarction (STEMI) patients, and 40 healthy volunteers. Platelet reactive units (PRU) were assessed with cartridge analyzer, and vasodilator-stimulated phosphoprotein (VASP) was measured by flow cytometry. There were no significant changes in pmiR-1 expression. Expressions of pmiR-21 and pmiR-126 were decreased, while pmiR-150 and pmiR-223 were increased in STEMI patients when compared to controls (all p < 0.01). However, only pmiR-126 exhibited correlation with plasma cardiac troponin I (r = - 0.556, p = 0.011) in STEMI. There was no correlation between pmiRNAs with PRU or VASP during admission, or at 48h post-stenting. Among tested pmiRNAs, pmiR-126 may serve as a potential novel biomarker for STEMI, while pmiR-1, pmiR-21, pmiR-150, and pmiR-223 were not particularly useful. Moreover, since assessed pmiRNA expression did not correlate well with platelet activity indices their potential diagnostic utility is quite limited.

Mean Platelet Volume in Pemphigus Vulgaris.

Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucous membranes. The mean platelet volume (MPV) is an index of platelet activation reported to be influenced by inflammation. We investigated the MPV in patients with PV relative to controls. This case-control study included 160 patients with PV and 640 age- and sex-matched controls. The MPV, platelet count, and other inflammatory parameters were measured for all study participants. A significantly decreased MPV was observed in patients with PV compared with controls, 9.1 (1.5) fL versus 10.3 (1.4) fL, P < .001. A significant negative association between MPV and PV was demonstrated in multivariate analysis (odds ratio, 0.59; 95% confidence interval, 0.51-0.68, P < .0001). Patients having PV with laryngeal involvement had significantly lower MPVs than those without involvement of the larynx, 8.81 (1.5) fL versus 9.32 (1.4) fL, P = .032. Disease activity (before and after treatment) does not affect the MPV. Patients with PV showed decreased MPV values compared to healthy controls. The MPV may be a feasible diagnostic marker in patients with PV.

Cancer antigen 15-3, platelet distribution width, and fibrinogen in combination to distinguish breast cancer from benign breast disease in non-conclusive mammography patients

Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer death among females. However, mammographic diagnosis is sometimes non-conclusive with a Breast imaging Reporting and Data System (Bi-RaDS) result of 0. Cancer antigen 15-3 (CA15-3) is the most widely used serum tumor marker for breast cancer screening. Platelet distribution width (PDW) is an early indicator of platelet activation. Fibrinogen contributed to angiogenesis and distant metastasis. The aim of this study was to investigate the ability of CA15-3, PDW, and fibrinogen individually or in combination, to distinguish breast cancer from benign breast disease. 200 consecutive patients with breast cancer and 187 patients with benign breast disease were included in this retrospective study. Patients’ characteristics and hematologic tests data at initial diagnosis were collected. The benefit of adding PDW and fibrinogen to a model with only CA15-3 was evaluated as an increased in the area under the curve (AUC) obtained by receiver operating curve (ROC). CA15-3, PDW and fibrinogen are higher in breast cancer patients than in patients with benign breast disease. Single biomarkers had AUC values ranging from 0.687 for fibrinogen to 0.810 for CA15-3. In addition, the combination of PDW, CA15-3, and fibrinogen increased the AUC to 0.900 (0.866-0.928) (p<0.0001), significantly higher than those of any single marker. In conclusion, the combined use of CA15-3, PDW and fibrinogen may be clinically useful in discriminating between breast cancer and benign breast disease in non-conclusive mammography patients.

Mean platelet volume, platelet distribution width and carcinoembryonic antigen to discriminate gastric cancer from gastric ulcer.

Activated platelets are involved in cancer development and progression. Mean platelet volume (MPV) and platelet distribution width (PDW) are early indexes of platelet activation. The objectives of this study were to investigate the ability of MPV, PDW and carcinoembryonic antigen (CEA) individually or in combination, to distinguish between gastric cancer and gastric ulcer. The study involved 194 patients with gastric cancer, 191 patients with gastric ulcer, and 185 control subjects. Subjects’ characteristics and hematologic tests data at initial diagnosis were collected. We found that MPV levels are significantly increased and PDW levels are significantly reduced in patients with gastric ulcer and in control subjects compared with those in gastric cancer. When the area under the curve (AUC) was used to analyze control subjects versus gastric cancer, the combination of PDW and CEA exhibited a significantly larger AUC of 0.939 (0.910-0.961) compared with the combination of MPV and CEA (p = 0.0045). When AUC was used to analyze gastric ulcer versus gastric cancer, PDW alone had the high specificity (98.5%) and high sensitivity (97.4%). In conclusion, combined use of MPV, PDW and CEA can accurately distinguish gastric cancer from gastric ulcer and controls. Further studies in larger samples are warranted.

Mean Platelet Volume: A Reliable Marker of Inflammation in Recurrent Apthous Stomatitis and Behçet Disease?

Background:Mean platelet volume (MPV) is an indicator of platelet activation and aggregation. MPV has been found to be related with the inflammation of certain disorders in recent studies.Aims:We sought to investigate whether MPV could be an indicator of inflammation in patients with Behçet disease (BD) and recurrent apthous stomatitis (RAS).Materials and Methods:Our study was designed as a retrospective case-control study and data was retrieved from our institutional database. We randomly generated a total of three study groups from our clinical archive. All controls were sex and age-matched and randomly selected by computer. Eighty-five patients with BD, 82 patients with RAS, and 721 healthy controls were included for the study design. We compared mean MPV values in the patient groups and controls.Results:We found no difference in the mean MPV value between BD group and BD-control group. The mean MPV value was significantly higher in patients with RAS than that in the RAS-control group (9.11 ± 1.01 fL vs. 8.76 ± 1.15 fL, P = 0.045). There was no difference in mean MPV level between BD and RAS group.Conclusion:The association between MPV and inflammatory skin diseases such as BD and RAS should be investigated prospectively in case-control studies.Limitations:Retrospective study design.

Long-term serial changes in platelet activation indices following sirolimus elution and bare metal stent implantation in patients with stable coronary artery disease

BackgroundPlatelet activation is crucial in the development of stent thrombosis following percutaneous coronary intervention (PCI). We carried out a long-term assessment of multiple factors implicated in the thrombotic process and monitored markers of platelet activation after the implantation of sirolimus-eluting stents (SES) in patients with stable coronary artery disease (CAD). Additionally, we compared these findings with those after bare-metal stent (BMS) implantation. MethodsA cohort of 47 consecutive patients, aged <70 years, with severe stenosis (>70% narrowing of the lumen) of one major epicardial coronary artery and stable CAD underwent successful elective PCI. Patients were randomly allocated to SES (n = 25) or BMS (n = 22). Venous blood was obtained 24 hours before and 24 hours, 48 hours, 1 month, and 6 months after PCI for measurements of plasma levels of sP-selectin, von Willebrand Factor (vWF), fibrinogen, d-dimer, sCD40, factor VIII, b-thromboglobulin (b-TG) and platelet factor 4 (PF-4). ResultsThere were no significant differences between the two groups in levels of fibrinogen or d-dimers in peripheral blood. However, we observed a significant kinetic effect (p<0.001) and stent-effect (p<0.015) on vWF levels and a significant kinetic effect (p = 0.012) on factor VIII, sP-selectin (p = 0.04), b-TG (p<0.001), and PF4 (p = 0.016). A trend towards a significant stent effect on sCD40 was also detected (p = 0.06). ConclusionsSES and BMS did not show significant differences in relationship to markers of platelet activation and coagulation in patients with stable CAD. Although some markers showed an increase after stent implantation, they returned to the initial levels 6 months later.

Relative analysis of platelet activation with bleeding risk in patients with primary immune thrombocytopenia

目的研究原发免疫性血小板减少症（ITP）患者血小板活化状态和出血程度的相关性。方法采用ITP特异性出血评价工具（ITP-BAT）对43例ITP患者进行出血评分及出血程度分级，应用流式细胞术检测二磷酸腺苷（ADP）激活前后血小板膜糖蛋白（GP）Ⅰb、Ⅱb/Ⅲa和P选择素表达。分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与血小板计数、未成熟血小板比例的相关性；分析GPⅠb、GPⅡb/Ⅲa、P选择素表达与ITP患者出血程度的相关性，以及对中度以上出血患者风险评估的应用价值。结果ITP患者激活前血小板GPⅡb/Ⅲa、P选择素表达均高于正常对照组（65.69±10.73对7.16±0.99，t=4.130，P<0.001；15.43±1.41对12.55±1.03，t=2.070，P=0.043），GPⅠb表达低于正常对照组（240.11±24.93对295.11±22.15，t=2.417，P=0.020）。ITP患者ADP激活后血小板GPⅡb/Ⅲa表达高于正常对照组（133.96±12.17对39.67±4.99，t=5.256，P<0.001），而P选择素、GPⅠb表达低于正常对照组（37.09±3.94对109.77±23.66，t=3.901，P<0.001；149.06±19.14对205.73±21.00，t=2.070，P=0.043）。ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后GPⅠb、P选择素表达比值与血小板计数相关（P<0.05）。ADP激活后P选择素表达、ADP激活前后P选择素表达比值与未成熟血小板比例相关（P<0.05）。ITP患者ADP激活后GPⅠb表达、ADP激活前后P选择素表达及ADP激活前后P选择素、GPⅡb/Ⅲa、GPⅠb表达比值在不同出血程度之间差异有统计学意义（P<0.05）。ADP激活前后GPⅠb表达比值是ITP患者中度以上出血的正性影响因素（OR=3.05，P=0.011），ADP激活前后P选择素、GPⅡb/Ⅲa表达比值是ITP患者中度以上出血的负性影响因素（OR=0.32，P=0.023；OR=0.04，P=0.006）。结论血小板活化指标能较准确地评估ITP患者出血程度，可以作为治疗参考指标和疗效观察指标。

Preoperative mean platelet volume and platelet distribution associated with thyroid cancer.

Thyroid cancer is the most frequent cancer of the endocrine glands and the fifth most frequent cancer in women. Activated platelets play a crucial role in thrombosis, inflammation, and cancer. Mean platelet volume (MPV) and platelet distribution width (PDW) are early index of platelet activation. The purpose of this study is to investigate platelet indices levels in thyroid cancer. The study enrolled 280 patients with thyroid cancer and 280 control subjects. Patients' characteristics and hematologic tests data were collected at the time of diagnosis. Correlations between platelet indices and clinical characteristics were analyzed. The odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid cancer were calculated using multivariate logistic regression analyses across MPV and PDW quartiles. The patients with thyroid cancer had lower MPV and higher PDW compared with control subjects. MPV was correlated with tumor-nodus-metastases (TNM) stage and lymph node metastasis. Moreover, after adjusting for other risk factors, the prevalence risk of thyroid cancer for the lowest quartile of MPV was 7.242 (4.069-12.887) (P < 0.001) and for the highest quartile of PDW was 6.065 (3.321-11.076) (P < 0.001), respectively. The study showed that the patients with thyroid cancer have lower MPV and higher PDW compared to control subjects. Moreover, MPV and PDW were independently associated with the presence of thyroid cancer. Further studies are needed to evaluate the utility of MPV and PDW as novel diagnostic screening tools for thyroid cancer.

Decreased Mean Platelet Volume is Associated with Cervical Cancer Development

Background:Cervical cancer is the most common gynecological malignant disorder worldwide. Activated platelets play a key role in cancer development and progression. Mean platelet volume (MPV) is an early indicator of platelet activation. The aim of the present study was to evaluate MPV levels in patients with cervical cancer.Materials and methods:A total of 181 patients with cervical cancer and 181 controls between January 2015 and June 2015 were included in the study. Patient characteristics and hematologic test data at initial diagnosis were collected and odds ratios (ORs) and 95% confidence intervals (CIs) for risk of cervical cancer were calculated using multivariate logistic regression analyses across MPV quartiles.Results:MPV levels were decreased in patients with cervical cancer compared with control subjects. A significant correlation between MPV and FIGO stage was found. Moreover, after adjusting for other risk factors, the ORs (95%CIs) for cervical cancer according to MPV quartiles were 4.450 (1.975-10.026), 2.505 (1.206-5.202), 0.573 (0.261-1.259), and 1.000, respectively.Conclusions:MPV was found to be independently associated with the presence of cervical cancer. Our results suggest that MPV could be potential diagnostic screening tool.

Platelet Distribution Width and Serum Albumin Levels for Discrimination of Thyroid Cancer From Benign Thyroid Nodules

Thyroid cancer is the most rapidly increasing cancer type among women and the second among men. Early detection greatly improves the prognosis. For this purpose, the platelet distribution width (PDW), an early indicator of platelet activation, might be useful. The aim of this study was to investigate the ability of PDW and serum albumin levels individually or in combination to distinguish between thyroid cancer and benign thyroid nodules. A total of 265 patients with thyroid cancer and 243 with benign thyroid nodules were included in a development set. Then, two groups of 130 cases were enrolled in a validation set. Patient characteristics and hematologic test data at initial diagnosis were collected. Receiver operating characteristic curves (ROC), area under the curve (AUC) values, sensitivity and specificity were estimated. Albumin levels are significantly lower and PDW significantly higher in patients with thyroid cancer compared to the benign cases. Moreover, PDW values prominently differed among three types of thyroid cancer. In addition, the combination of PDW and albumin exhibited a significantly larger AUC than either marker alone (p < 0.001). In conclusion, the combined use of PDW and albumin might be useful in distinguishing thyroid cancer from benign thyroid nodules. This promising approach could be helpful in early detection of thyroid cancer.

Fli1 Expression Level Affects Megakaryopoiesis and Thrombopoiesis: More Is Not Always a Bad Thing

Friend leukemia integration 1 (FLI1) is a critical transcription factor responsible for terminal megakaryocyte differentiation. This transcription factor is amongst the genes missing in the inherited disorder Jacobsen syndrome, resulting from a hemizygous deletion on chromosome 11q. The deletion causes dysmegakaryopoiesis and macrothrombocytopenia termed Paris Trousseau syndrome (PTSx). Also, FLI1 mutations in its DNA-binding domain region results in thrombocytopenia in affected patients. We examined induced pluripotent stem cell- (iPSC) derived megakaryocytes (iMegs) to determine if the platelet disorder observed in PTSx could be replicated and if varied levels of Fli1 expression affected megakaryopoiesis and thrombopoiesis. Beginning with a normal control (WT) iPSC line, genome editing was performed to generate three lines with: 1) one copy of FLI1 disrupted (FLI1+/-), 2) hemizygous transgene expression of Fli1 in the adeno-associated virus site 1 (AAVS1) safe harbor locus using a megakaryocyte-specific GP1balpha promoter (WT-overexpressing line, WT-OE), and 3) homozygous transgene expression in AAVS1 (WT-OE2). Additionally, we established an iPSC line from a PTSx patient and edited this line for a similar hemizygous transgene expression of FLI1 (PTSx-OE). Data described here are summarized in the tables below. We confirm our genome editing strategies by examining mRNA and protein levels of iMegs and found WT-OE and WT-OE2 iMegs have ~3X higher mRNA and ~7X higher protein levels than WT iMegs. FLI1+/- and PTSx iMegs both have lower mRNA and ~0.5X the protein levels of WT iMegs, while PTSx-OE iMegs had comparable levels of mRNA and protein as WT-OE iMegs. Megacult colony assays showed WT-OE and WT-OE2 yielded more CFU-Megs than WT HPCs (p²0.01, p²0.05, respectively). PTSx and FLI1+/- had much less CFU-Megs compared to PTSx-OE and WT (p²0.0001). After growth in liquid culture, WT-OE and -OE2 lines had an increase in iMeg numbers (p=0.29, p²0.01) while FLI1+/- and PTSx iMeg numbers were 43% and 10% that of the WT control (p²0.01, p²0.001). PTSx-OE iMeg numbers were comparable to WT. Surface marker CD41 and CD42b levels were increased compared to WT iMegs in the WT-OE and -OE2 iMegs (p=0.25, p²0.05) and less on FLI1+/- and PTSx iMegs (p²0.01, p²0.05). PTSx-OE iMegs were normal compared to WT, but p²0.05 vs. PTSx. Infused CD41+CD42b+ iMegs into NSG mice showed a trend toward same yield of platelets in the OE lines and lower yield in FLI1+/- and PTSx lines compared to WT. However, when calculations were made from HPCs rather than iMegs infused, the FLI1+/- and PTSx iMegs generated significantly less number of released platelets (p²0.05, p²0.01). The half-life of WT-OE and -OE2 released platelets were increased at 4 and 10 hours compared to WT, whereas FLI1+/- and PTSx released platelets have lower half-lives of 2 hours and 0.5 hours, respectively. These decreased platelet half-lives are due to the majority of platelets being defective and cleared at a higher rate. This was corrected to WT in the PTSx-OE-released platelets. Both in vitro iMegs and in vivo released platelets within the murine blood were assessed for function. Analysis of activation by thrombin was performed via FACS for PAC-1 binding and cell surface P-selectin levels, which are both indicators of platelet activation. Initial studies show no difference between WT and the WT-OE and WT-OE2 lines, but FLI1+/- platelet activation was slightly impaired. In summary, we show that studies of iMegs with decreased Fli1 levels replicate many of the clinical features previously described: less iMegs, lower CD41 and CD42b density with less platelets released while having shorter half-lives. On the other hand, increased Fli1 levels resulted in higher number of iMegs with more surface antigen density and released platelets with increased half-lives. Based on overexpression studies of other transcription factors during megakaryopoiesis, such as GATA1, the expectation would have been that the excess of Fli1 in the OE lines would have also resulted in defects in megakaryopoiesis and thrombopoiesis, but instead improvements were seen. The basis for this difference when overexpressing different transcriptional factors needs further analysis. That high Fli1 levels enhance iMeg yield with maintained numbers and function of released platelets may be of value for generating platelets for clinical use from in vitro grown Megs. [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Hemoglobin Level and Platelet Size Predicts Grey and White Matter Volume Loss Measured By Tensor Based Morphology in Sickle Cell Disease

▪Background: Sickle cell disease (SCD) is a life-threatening genetic disease whose patients suffer from chronic anemia, hemolysis, vascular damage, and impaired cerebral blood flow that lead to early and cumulative neurological insults. Adverse effects associated with chronic anemia and hemolysis in SCD include progressive large vessel vasculopathy, stroke, silent cerebral infarctions, and ultimately, early mortality. Few studies have attempted to characterize the effects of this disease on brain morphometry and most have been limited to school age children, despite the progressive nature of the cerebrovascular disease. Thus, this study aims to quantify the hematological effects of SCD on brain morphometry in adolescents and young adults.Methods: 3D T1-weighted images (TE =3.8ms TR =8.3ms; resolution = 1mm3) were acquired on 25 clinically asymptomatic SCD patients (age=20.8 ± 6.7; F=13, M=12) and 26 ethnically matched control subjects (age=26.4 ± 7.7; F=17, M=9). MRI data were acquired on a 3T Philips Achieva (v.3.2.1) using an 8-channel head coil. All patients were recruited with informed consent or assent; the study was approved by the Institutional Review Board at Children’s Hospital Los Angeles (CCI#11-00083). Exclusion criteria included pregnancy, previous overt stroke, acute chest, or pain crisis hospitalization within one month.T1-weighted images were processed using BrainSuite (brainsuite.org) in a semi-automated fashion to calculate whole brain gray matter volume (GMV), and white matter volume (WMV). Stepwise multivariate regression analysis was run on GMV and WMV against laboratory data and vital signs to find predictors of total brain volume. Laboratory data probed including complete blood counts and indices, quantitative hemoglobin electrophoresis, and markers of hemolysis (LDH, reticulocyte count, cell free hemoglobin). After correcting for age and sex, the remaining predictors of grey and white matter volume were used to probe for regional changes in brain volume through tensor based morphometry (Brain Suite Statistics Toolbox).Results: White matter, but not grey matter, was diffusely smaller in SCD patients. Sex, age (log transformed) and mean platelet volume (MPV) were the parameters retained in the multivariate model to predict GMV (r2=0.65; F ratio=28.9) where MPV had a positive correlation to GMV. Hemoglobin, sex, and MPV were found as predictors of WMV (r2=0.43; F ratio = 11.8) where both hemoglobin and MPV had a positive correlation to WMV.Using tensor based morphometry (TBM), both hemoglobin and MPV were positively associated with brain volume changes diffusely in the frontal, parietal, and temporal cortices (Figure 1). Hemoglobin had a strong localized effect on the subcortex (white matter and basal ganglia) (Figure 1) suggesting that anemia was associated with volume loss in these areas. MPV overall was found to have a strong effect on cortical morphology diffusely.Conclusion: Hemoglobin's relationship to brain volume and morphology suggests global white matter shrinkage due to anemia. The association is strongest in the phylogenetically younger portions of the brain and co-localizes with brain regions impacted by silent stroke. MPV was an unexpectedly strong predictor of cortical volumes in both SCD and control subjects. MPV is an indicator of platelet activation and is associated with ischemic stroke, hypertension, obstructive sleep apnea, and coronary artery syndromes in the general population, similar to C-reactive protein. However, the broad association of MPV and grey matter volumes in both SCD patients and controls, independently, suggests a developmental interplay between brain maturation and inflammatory signaling that requires further study. [Display omitted] DisclosuresWood:Celgene: Consultancy; Ionis Pharmaceuticals: Consultancy; AMAG: Consultancy; Apopharma: Consultancy; Apopharma: Consultancy; Biomed Informatics: Consultancy; Biomed Informatics: Consultancy; AMAG: Consultancy; Celgene: Consultancy; Vifor: Consultancy; Ionis Pharmaceuticals: Consultancy; World Care Clinical: Consultancy; Vifor: Consultancy; World Care Clinical: Consultancy.

Is there a relationship between mean platelet volume and the severity of coronary ectasia?

Mean platelet volume (MPV) is an indicator of platelet activation that is elevated in patients with coronary artery ectasia (CAE). We aimed to research relationship between MPV and the severity of coronary ectasia. The reports of 6,377 patients who underwent elective coronary angiography screening between January 2011 and January 2015 were reviewed. After exclusion, 117 patients with isolated CAE were included in this study. The severity of CAE was divided into four types according to the Markis classification. There was no significant difference in age, sex, hypertension, diabetes mellitus, smoking, or family history between the CAE and normal angiogram groups (P>0.05). MPV was significantly higher in patients with CAE than the control group (11.14 ± 1.13 vs. 9.82 ± 0.90 fL, P 10.85 fL may indicate the presence of CAE.

Abstract 12834: Increased Plasma Serotonin and Circulating microRNA-1914 Reflect Oxidative Stress and Play Crucial Roles in Atherosclerosis

Introduction: Serotonin, synthesized from enterochromaffin cells, modulates vascular tonus and thrombus formation, and mediates development of atherosclerotic plaque. Oxidative stress is involved in vascular inflammation and progression of atherosclerosis. Hypothesis: We hypothesized that plasma serotonin plays a crucial role in increasing oxidative stress and aimed to identify the circulating microRNA(s) associated with serotonin ratio for coronary artery disease (CAD). Methods: Blood was sampled from 120 outpatients with cardiovascular risk factors but without a history of previous cardiovascular events. Serotonin levels both in platelet poor plasma (PPP) and whole blood (WB) were measured with HPLC, and the ratio of serotonin in PPP to that in WB (PPP/WB) was used as an index of platelet activation. For assessment of oxidative stress, serum levels of derivative reactive oxygen metabolites (d-ROM) were measured. Total RNA was isolated from subjects who were scheduled for coronary angiography with suspicion of CAD and a microRNA array analysis was performed. The expression levels of microRNAs were scaled by global normalization. Results: Serotonin levels in both PPP and PPP/WB ratio were significantly correlated with the d-ROM levels. Among enrolled patients, 25 subjects were diagnosed as having CAD. The levels of the PPP/WB ratio of serotonin, d-ROM, and CRP were significantly higher in subjects with CAD than in those without CAD. Logistic regression analysis performed with endpoint of having CAD revealed that the PPP/WB ratio of serotonin was independently associated with CAD. In subjects with CAD, 5 increased microRNAs and 30 decreased microRNAs were identified among more than 2000 microRNAs as compared to those without CAD. Among candidate microRNAs, expression of microRNA-1914 showed significant inverse correlation with PPP/WB ratio (r=-0.61, P&lt;0.05) and d-ROM levels (r=-0.63, P&lt;0.05). Conclusions: A significant association among platelet activation assessed by PPP and PPP/WB ratio and oxidative stress assessed by d-ROM, was detected in individuals with cardiovascular risk factors. Targeting serotonin-oxidative stress axis, and circulating microRNA-1914 may serve as novel strategy for diagnosis of atherosclerotic CAD.

MEAN PLATELET VOLUME DI STROK

Ischemic stroke is the cause of most cases which occur due to obstruction, this pathogenesis can be caused by the formation of thrombus in the cerebrum blood vessels. Platelet aggregation plays a role in the pathogenesis of thromboembolic cerebrovascular disease. Platelets size, measured as Mean Platelet Volume (MPV) is a marker of platelet function and is associated with the indicator of platelet activity. Several studies have found that there was an increased of MPV in acute ischemic stroke while the correlation with the severity and outcome of stroke was still controversial. The aim of study is to determine the MPV and their association with outcomes in acute ischemic stroke patients. A cohort study during May up to July 2010 was carried out, the researchers measured MPV and analyze their correlation with its outcome using modified Rankin scale score 10 days after the onset in 33 acute ischemic stroke patients. The mean of MPV for the first three days of the onset was 8.9 fl, on the 5th day was increased up to 9.4 but at the 10th day of onset the MPV remains the same value as the 5th day. The MPV of first three days and 5th day have a positive correlation, but insignificant with their outcome, with p values 0.158 and 0.06, respectively. From this study can be concluded that the increased of MPV on the fifth day onset did not have any significant correlation with the outcome of acute ischemic stroke illness.

Oxidative stress and platelet activation during on-pump and off-pump coronary artery bypass grafting in patients with double grafted vessels

ABSTRACTThis study aimed to evaluate the oxidative stress status and two markers of platelet activation and reactivity in off-pump versus on-pump coronary artery bypass surgery. Study groups of 65 patients with double coronary artery bypass grafting were divided into cardiopulmonary bypass (CPB) and off-pump coronary artery bypass groups. In serial blood samples, lipid hydroperoxides (LOOH), serum paraoxonase (PON1), advanced oxidation protein products (AOPP), total sulfhydryl groups (tSHG) and red blood cell distribution width (RDW) to platelet (Plt) ratio (RPR) and mean platelet volume (MPV) to platelet (Plt) ratio (MPR) index were determined to compare the extent of oxidative stress and platelet activation. The MPR and RPR rose significantly in the post-operative period (P < 0.001) in both groups. The increase was higher in the CPB group, but this difference reached borderline significance at 48 h post-operatively. The AOPP/tSHG index increased 6 h after surgery, preceded by a significant fall of the PON1/LOOH ratio, more evident in the CPB group. Multiple linear regression analysis showed explicit connection between these markers and surgery-related clinical conditions. Receiver operating characteristic analysis enabled estimation of the clinical accuracy of oxidative plus platelet-related indices in prediction of surgery caused complications (area under the curve for the model consisted of oxidative stress parameters and platelet activation indices was above 0.9, P < 0.001). Results showed higher oxidative stress and undesirable platelet activation in the CPB group. Oxidative status markers and platelet activity indices showed good clinical accuracy to predict the development of possible surgical complications.

Thrombocytopenia after sutureless aortic valve implantation: Comparison between Intuity and Perceval bioprostheses

Thrombocytopenia after sutureless aortic valve implantation: Comparison between Intuity and Perceval bioprostheses

Mean platelet volume is increased in patients with chronic hepatitis B

Background. Hepatitis secondary to infection with the hepatitis B virus (HBV) is one of the most common causes of viral hepatitis worldwide. Multiple extrahepatic manifestations of HBV infection have been recognized. However, the effect of HBV infection on the mean platelet volume (MPV) is unknown. The aim of this study was to assess the MPV, an indicator of platelet activation, in patients with chronic hepatitis B. Methods. The study group consisted of 50 patients with chronic hepatitis B. An age, gender, and body mass index-matched control group consisted of 50 healthy volunteers. All patients and control participants underwent echocardiographic examination. We measured the serum MPV values in patients and control participants. Results. Mean platelet volume was significantly higher among patients with HBV when compared with the control group (9.2±2.2 vs 7.1±1.6 fl, respectively; p <0.001). Conclusion. We have shown that MPV was significantly elevated in patients with chronic hepatitis B compared to control participants. According to our knowledge, there has been no previous study of MPV in chronic HBV patients. Therefore, we have investigated the possible association between HBV infection and MPV.