Platelet Microvesicles (Microparticles) in Cardiac Surgery

Tempo, Jake A.; Englyst, Nicola A.; Holloway, Judith A.; Smith, David C.

doi:10.1053/j.jvca.2015.08.001

Cited by 7 publications

(6 citation statements)

References 80 publications

(88 reference statements)

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“…According to previous researches, CRP, IL-6 and IL-8 induced by the surgical trauma are associated with the level of inflammatory response in patients [1,11,23]. In addition, the complement system and fibrinolysis are also activated [24][25]. In our study, we demonstrated that the level of CRP significantly increased in postoperative patients, and was greater after on-pump group.…”

Section: Discussionsupporting

confidence: 63%

Circulating Microvesicles Mediate the Inflammatory Response and Coagulopathy in Coronary Artery Bypass Graft Surgery

Xue¹,

Wei²,

Yang³

et al. 2021

COS

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Section: Discussionsupporting

confidence: 63%

Circulating Microvesicles Mediate the Inflammatory Response and Coagulopathy in Coronary Artery Bypass Graft Surgery

Xue¹,

Wei²,

Yang³

et al. 2021

COS

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“…During CPB, complement activation and inflammatory response are aggregated and contributes to the release of MPs as predicted. The conflict results may be due to adhesion of PMP to CPB circuit, hemodilution or mechanical cell salvage during CPB (29). Another reason may be the detective limit of FCM, which are unable to measure the MPs (mainly ranging 100-300 nm) less than 300 nm (21,30).…”

Section: Discussionmentioning

confidence: 99%

“…The glomerulus endothelial dysfunction is the initial step of AKI (34). The changes of EMP reflect the conditions of endothelial function and glomerulus endothelial function (8,19,29,37).…”

Section: Discussionmentioning

confidence: 99%

Circulating endothelial microparticles: a promising biomarker of acute kidney injury after cardiac surgery with cardiopulmonary bypass

Ma¹,

Yuan²,

Chen³

et al. 2021

Ann Transl Med

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Background: Current diagnostic strategies for acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB) are nonspecific and limited. Previously, we demonstrated that circulating microparticles (MPs) in patients with valve heart disease (VHD) and congenital heart diseases (CHD) induce endothelial dysfunction and neutrophil chemotaxis, which may result in kidney injury. We also found that circulating MPs increase after cardiac surgery with CPB and are related to cardiac function. However, the relationship between circulating MPs and AKI after CPB is unknown.Methods: Eighty-five patients undergoing cardiac surgery with CPB were enrolled. Patients were divided into AKI and non-AKI groups based on the serum creatinine levels at 12 h and 3 d post-CPB. Circulating MPs were isolated from plasma, and their levels including its subtypes were detected by flow cytometer. Independent risk factors for the CPB-associated AKI (CPB-AKI) were determined by multivariate logistic regression analysis. Receiver operating characteristic (ROC) analysis was used to measure the prognostic potential of CPB-AKI.Results: The morbidity of AKI at 12 h and 3 d after cardiac surgery with CPB was 40% and 31.76%, respectively. The concentrations of total MPs and platelet-derived MPs (PMP) remained unchanged at 12 h and then increased at 3 d post-CPB, while that of endothelial-derived MPs (EMP) increased at both time points. In patients with AKI, PMP and EMP were elevated compared with the patients without AKI. However, no significant change was detected on monocyte-derived MPs (MMP) at 12 h and 3 d post-CPB.The logistic regression analysis showed that EMP was the independent risk factor for AKI both at 12 h and 3 d post-CPB. The area under ROC for the concentrations of EMP at 12 h and 3 d post-CPB was 0.86 and

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“…Shear forces of the pump cause cellular activation and/or destruction of platelets, leucocytes and red cells. Microvesicles from platelets are produced during CPB and are highly thrombogenic and proinflammatory . Red cell destruction results in circulating free hemoglobin, which has been shown in in‐vitro studies to interact with the A1 domain of von Willebrand factor (VWF) and promote platelet adhesion .…”

Section: Introductionmentioning

confidence: 99%

Antithrombotic therapy management of adult and pediatric cardiac surgery patients

Kreuziger

Karkouti

Tweddell

et al. 2018

Journal of Thrombosis and Haemostasis

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Despite the development of catheter-based interventions for ischemic and valvular heart disease, hundreds of thousands of people undergo open heart surgery annually for coronary artery bypass graft (CABG), valve replacement or cardiac assist device implantation. Cardiac surgery patients are unique because therapeutic anticoagulation is required during cardiopulmonary bypass. Developmental hemostasis and altered drug metabolism affect management in children. This narrative review summarizes the current evidence-based and consensus guidelines regarding perioperative, intraoperative and postoperative antithrombotic therapy in patients undergoing cardiac surgery. Anticoagulation preoperatively is required in the setting of cardiac arrhythmias, prior valve replacement or history of venous thromboembolism. In patients with ischemic heart disease, aspirin is continued in the perioperative period, whereas oral P2Y antagonists are withheld for 5-7 days to reduce the risk of perioperative bleeding. Intraoperative management of cardiopulmonary bypass in adults and children includes anticoagulation with unfractionated heparin. Variability in dose-response to heparin and influence of other medical conditions on dosing and reversal of heparin make intraoperative anticoagulation challenging. Vitamin K antagonist therapy is the standard anticoagulant after mechanical heart valve or left ventricular assist device (LVAD) implantation. Longer duration of dual antiplatelet therapy is recommended after CABG if patients undergo surgery because of acute coronary syndrome. Antiplatelet therapy after LVAD implantation includes aspirin, dipyridamole and/or clopidogrel in children and aspirin in adults. A coordinated approach between hematology, cardiology, anesthesiology, critical care and cardiothoracic surgery can assist to balance the risk of thrombosis and bleeding in patients undergoing cardiac surgery.

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Platelet Microvesicles (Microparticles) in Cardiac Surgery

Cited by 7 publications

References 80 publications

Circulating Microvesicles Mediate the Inflammatory Response and Coagulopathy in Coronary Artery Bypass Graft Surgery

Circulating Microvesicles Mediate the Inflammatory Response and Coagulopathy in Coronary Artery Bypass Graft Surgery

Circulating endothelial microparticles: a promising biomarker of acute kidney injury after cardiac surgery with cardiopulmonary bypass

Antithrombotic therapy management of adult and pediatric cardiac surgery patients

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