Platelet Subtypes in Inflammatory Settings

Hamad, Muataz Ali; Krauel, Krystin; Schanze, Nancy; Gauchel, Nadine; Stachon, Peter; Nuehrenberg, T; Zurek, Mark; Duerschmied, Daniel

doi:10.3389/fcvm.2022.823549

Cited by 5 publications

(4 citation statements)

References 97 publications

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“…In partial thrombosis in false lumen, organ ischemia may occur, and further, thrombus and platelets can modulate inflammatory reactions and immune responses. [13] [14] Although it remains unknown how anti-thrombotic drugs work on the thrombus formation in false lumen, the present study indicated that anti-thrombotic drugs did not worsen the prognosis in patients with acute aortic dissection. The mechanisms how anti-thrombotic drugs work in acute aortic dissection should be clarified in near future.…”

Section: Discussionmentioning

confidence: 66%

Safety of anti-thrombotic therapy in acute aortic dissection; single center, observational study

Hori

Morikawa

Tayama

2022

Preprint

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BackgroundAcute aortic dissection occurs due to a primary tear in aortic intima, with blood from aortic lumen penetrating into diseased media, in which anti-thrombotic therapies may be harmful. We examined the prognosis in patients, who had already taken antithrombotic therapies at the onset of acute aortic dissection, and the safety to administer anti-thrombotic drugs in acute phase during hospitalization.Methods and ResultsWe retrospectively enrolled 685 patients with acute aortic dissection (type A/B: 454/231), who were transferred to Kurume University Hospital from 2004 to 2020. In both type A and B, there were no significant differences in in-hospital mortality between with and without antithrombotic therapies at the onset. Patients, who survived more than a day and administered anti-thrombotic drugs during hospitalization, had significantly lower in-hospital mortality than those who had no anti-thrombosis in acute phase in type A, while there was no significant difference in in-hospital mortality between the 2 groups in type B.ConclusionsWe demonstrated that anti-thrombotic drugs did not worsen the prognosis in patients with acute aortic dissection, indicating that we should not hesitate anti-thrombotic drugs if indicated.

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Section: Discussionmentioning

confidence: 66%

Safety of anti-thrombotic therapy in acute aortic dissection; single center, observational study

Hori

Morikawa

Tayama

2022

Preprint

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“…Emerging evidence on subtypes of platelets may eventually explain the complex effects of platelet transfusion on mortality. Some subtypes of platelets may be protective while other proinflammatory subtypes may be harmful 35 . It is also possible that patients received platelets because they had disseminated intravascular coagulation, but this detail is not available in TQIP.…”

Section: Discussionmentioning

confidence: 99%

“…Some subtypes of platelets may be protective while other proinflammatory subtypes may be harmful. 35 It is also possible that patients received platelets because they had disseminated intravascular coagulation, but this detail is not available in TQIP. Prospective studies will be needed to better characterize the effects of platelet transfusion on hemostasis, inflammation, and survival in injured children.…”

Section: Discussionmentioning

confidence: 99%

Association of blood product ratios with early mortality in pediatric trauma resuscitation: A time-dependent analysis from the National Trauma Databank

Snyder

Neff

Chandler

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND:Injured children with severe hemorrhage often receive blood product transfusions with ratios of plasma and platelets to packed red blood cells (PRBCs) approaching 1:1:1. Whether blood product ratios vary during pediatric resuscitation is unknown. This study (1) described precise timing of pediatric blood product administration, (2) characterized changes in blood product ratios over time, and (3) evaluated the association of blood products with early mortality while incorporating time-varying factors. METHODS:Pediatric (younger than 18 years) trauma patients receiving high-volume transfusion (>40 mL/kg total products or >2 U PRBC or whole blood, during first 4 hours) were obtained from the 2017 to 2019 Trauma Quality Improvement Program database. The time of each individual product transfusion was recorded, along with demographics, injury details, and times of death. Patients were assigned to blood product groups at 15-minute intervals: high plasma/PRBC ratio (>1:1) with platelets, high plasma/PRBC ratio (>1:1) without platelets, low plasma/PRBC ratio (<1:1), PRBC only, and whole blood. Cox proportional hazards modeling for 24-hour mortality was performed, including blood product group as a time-varying variable and adjusting for relevant covariates. RESULTS:Of 1,152 included patients (median age, 15 years; 32% penetrating, 28% severe traumatic brain injury [sTBI]), 18% died within 24 hours. During the resuscitation period, the number of patients in high-ratio groups increased over time, and patients switched blood product groups up to six times. There was no significant difference in mortality by blood product group. Among patients with sTBI, there was a strong trend toward lower mortality among high plasma/PRBC without platelets versus high plasma/ PRBC with platelets (hazard ratio, 0.55; p = 0.07). CONCLUSION:No significant association of high ratios or whole blood with mortality was seen when time-varying factors were incorporated. The impact of balanced resuscitation strategies, particularly platelet transfusion, may be greatest among patients with sTBI. Optimizing balanced resuscitation for children requires appropriately designed prospective studies.

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“…In addition, complete thrombus may be able to relieve pressure from the tear; however, it may conversely cause organ ischemia. Furthermore, in cases of partial thrombosis in the false lumen, thrombus and platelets can modulate inflammatory reactions and immune responses [ 10 , 11 ]. It remains unknown how anti-thrombotic drugs affect thrombus formation in the false lumen.…”

Section: Introductionmentioning

confidence: 99%

Use of Anti-Thrombotic Drugs and In-Hospital Mortality in Acute Aortic Dissection Patients

2022

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Acute aortic dissection occurs due to a primary tear in the aortic intima, with blood from the aortic lumen entering the adjacent diseased media. In the clinical setting, practitioners often hesitate before the use of anti-thrombotic drugs in the acute phase of aortic dissection. Therefore, we examined the clinical course in patients who had already received antithrombotic therapies at the onset of acute aortic dissection, and who were given anti-thrombotic drugs in the acute phase during hospitalization. We retrospectively enrolled 685 consecutive patients with acute aortic dissection (type A/B: 454/231), who were transferred to Kurume University Hospital from 2004 to 2020. In types A and B, there were no significant differences between in-hospital mortality with or without antithrombotic therapies at the onset (14.3% vs. 16.4%, p = 0.66 in type A, 2.6% vs. 7.3%, p = 0.29 in type B). Patients in type A who survived more than a day and were treated with anti-thrombotic drugs during hospitalization had significantly lower in-hospital mortality compared with those who received no anti-thrombotic drugs in the acute phase (2.2% vs. 16.1%, p < 0.001), while there was no significant difference between in-hospital mortality in the two type-B groups (2.4% vs. 4.9%, p = 0.48). Although there were variations in response among patients with acute aortic dissection, anti-thrombotic drugs did not worsen in-hospital mortality for patients with acute aortic dissection, indicating that medical staff should not hesitate to administer anti-thrombotic drugs if indicated.

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Platelet Subtypes in Inflammatory Settings

Cited by 5 publications

References 97 publications

Safety of anti-thrombotic therapy in acute aortic dissection; single center, observational study

Safety of anti-thrombotic therapy in acute aortic dissection; single center, observational study

Association of blood product ratios with early mortality in pediatric trauma resuscitation: A time-dependent analysis from the National Trauma Databank

Use of Anti-Thrombotic Drugs and In-Hospital Mortality in Acute Aortic Dissection Patients

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