Platelet activity and hypercoagulation in type 2 diabetes

Pretorius, Lesha; Thomson, Greig J. A.; Adams, Rozanne C. M.; Nell, Theo; Laubscher, Willem A.; Pretorius, Etheresia

doi:10.1186/s12933-018-0783-z

Cited by 98 publications

(83 citation statements)

References 44 publications

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“…slips. This has also previously been noted in various publications (Page et al, 2018;Pretorius et al, 2018d;Page et al, 2019).…”

Section: Thromboelastography Cholesterol and Hba1c Levels And Ultrasupporting

confidence: 83%

Parkinson’s disease: a systemic inflammatory disease accompanied by bacterial inflammagens

Adams

Nunes

Pagé

et al. 2019

Preprint

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Parkinson's disease (PD) is a well-known neurodegenerative disease. Recently, the role of gingipains from Porphyromonas gingivalis was implicated in Alzheimer's disease. Here we present evidence of systemic inflammation, accompanied by hypercoagulation; we also show that ginipains from P. gingivalis and its LPS may foster abnormal clotting, and that ginipains are present in PD blood, and thus that ginipain's action on blood may be relevant to PD pathology. Bloods from both PD and healthy blood samples were analysed using thromboelastography (TEG), confocal and electron microscopies, and for cytokine and other circulating biomarkers. We also probed PD and healthy plasma clots with a polyclonal antibody for the bacterial protease, gingipain R1, from P. gingivalis. Low concentrations of recombinant gingipain R1 were also added to purified fluorescent fibrinogen. TEG, fibrin(ogen) amyloid formation and platelet ultrastructure analysis confirmed profound hypercoagulation, while the biomarker analysis confirmed significantly increased levels of circulating proinflammatory cytokines. We provide evidence for the presence of the protease, gingipain R1 in PD blood, implicating inflammatory microbial cell wall products in PD.

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“…slips. This has also previously been noted in various publications (Page et al, 2018;Pretorius et al, 2018d;Page et al, 2019).…”

Section: Thromboelastography Cholesterol and Hba1c Levels And Ultrasupporting

confidence: 83%

Parkinson’s disease: a systemic inflammatory disease accompanied by bacterial inflammagens

Adams

Nunes

Pagé

et al. 2019

Preprint

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“…Thus, more evidence for the value of Fib in cardiovascular risk stratification in different subgroups were needed. and inflammatory processes in diabetes [22,29]. Impaired glucose metabolism and the status of insulin resistance result in oxidative stress, inflammatory response, coagulation activation, and accelerated atherosclerosis pathogenesis [30].…”

Section: Fib and Coronary Artery Diseasementioning

confidence: 99%

Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease

Liu

Shi

et al. 2020

Cardiovasc Diabetol

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Background: The present cohort study aims to examine the relationship between fibrinogen (Fib) levels and glucose metabolism [fasting blood glucose (FBG) and hemoglobin A1c (HbA1c)] and investigate the impact of high Fib on cardiovascular outcomes in patients with stable CAD and pre-diabetes mellitus (pre-DM) or diabetes mellitus (DM). Methods:This study included 5237 patients from March 2011 to December 2015. Patients were distributed into three groups according to Fib levels (low Fib, median Fib, high Fib) and further categorized by glucose metabolism status [normal glucose regulation (NGR), Pre-DM, DM]. All patients were followed up for the occurrences of major adverse cardiovascular events (MACEs), including cardiovascular mortality, nonfatal MI, stroke, and unplanned coronary revascularization.Results: Linear regression analyses showed that FBG and HbA1c levels were positively associated with Fib in overall CAD participants, either with or without DM (all P < 0.001). During an average of 18,820 patient-years of follow-up, 476 MACEs occurred. High Fib was independently associated with MACEs after adjusting for confounding factors [Hazard Ratio (HR): 1.57, 95% confidence interval (CI) 1.26-1.97, P < 0.001]. Furthermore, DM but not pre-DM was a significant predictor of MACEs (P < 0.001 and P > 0.05, respectively). When patients were stratified by both glucose metabolism status and Fib levels, high Fib was associated with a higher risk of MACEs in pre-DM (HR 1.66, 95% CI 1.02-2.71, P < 0.05). Medium and high Fib levels were associated with an even higher risk of MACEs in DM (HR 1.86, 95% CI 1.14-3.05 and HR 2.28, 95% CI 1.42-3.66, all P < 0.05). After adding the combination of Fib and glucose status to the Cox model, the C-statistic was increased by 0.015 (0.001-0.026). Conclusions:The present study suggested that Fib levels were associated with FBG and HbA1c in stable CAD patients. Moreover, elevated Fib was independently associated with MACEs in CAD patients, especially among those with pre-DM and DM, suggesting that Fib may provide incremental value in the cardiovascular risk stratification of pre-DM and DM patients.

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“…It was previously shown that thrombus and stents are adhesive due to the fibrin networks of the dense thrombus surface, determined by a range of initiators of thrombus formation [20]. Patients with diabetes mellitus show accelerated clot initiation caused by platelet activity and hypercoagulation, and adverse reaction milieu characteristics due to diabetes mellitus lead to a dysregulated clotting system [21,22]. In addition, diabetes mellitus indicates the formation of more compact fibrin networks in the thrombi [23], whilst red blood cells in the thrombi are mainly captured by fibrin networks during thrombi formation [24].…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Factors of Single Attempt of Stent Retrieval during Endovascular Thrombectomy for Acute Ischemic Stroke

M¹,

Y²,

Liu³

et al. 2020

Preprint

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Backgrounds: Single attempt of stent retrieval during endovascular thrombectomy (EVT) seems to be associated with favorable clinical outcomes of patients with acute ischemic stroke (AIS), but the relationship between single attempt and clinical outcomes or complications have not been characterized. In addition, the factors related to single retrieval attempts during EVT are undefined. Here, we investigated the relationship between single attempt of stent retrieval and the clinical outcomes or complications after EVT, and further investigated the factors associated with single attempt of stent retrieval in AIS patients. Methods: This study enrolled consecutive patients with AIS treated by EVT with second-generation stent retriever devices from April 2016 to April 2019. Attempts of EVT were classified as single or multiple attempts of stent retrieval after filtrating all enrolled patients based on inclusion and exclusion criteria. We analyzed the clinical outcomes and complications between single attempt of stent retrieval and multiple attempts of stent retrieval, and the factors independently associated with a single attempt were identified through logistical regression analysis. Results: We enrolled 143 patients, including 69 patients with single attempt of stent retrieval and 74 patients with multiple attempts of stent retrieval. More patients with single attempt of stent retrieval reached favorable clinical outcomes ( p =0.016; adjusted OR [95%CI]: 2.652 [1.204-5.843] ), and patients with single attempts of stent retrieval showed as a lower incidence of symptomatic intracranial hemorrhage (sICH) ( p =0.046; adjusted OR [95%CI]: 0.192 [0.038-0.973] ). Diabetes mellitus ( p =0.026; adjusted OR [95%CI]: 2.871 [1.137-7.249] ) was independently associated with single attempt of EVT with stent retrieval. Conclusions: Single attempt of stent retrieval during EVT can decrease incidence of sICH and improve favorable clinical outcomes of patients with AIS. Those with diabetes mellitus may be more prone to single attempt of stent retrieval during EVT .

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Platelet activity and hypercoagulation in type 2 diabetes

Cited by 98 publications

References 44 publications

Parkinson’s disease: a systemic inflammatory disease accompanied by bacterial inflammagens

Parkinson’s disease: a systemic inflammatory disease accompanied by bacterial inflammagens

Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease

Clinical Outcomes and Factors of Single Attempt of Stent Retrieval during Endovascular Thrombectomy for Acute Ischemic Stroke

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