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Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection

Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. Th...

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Autores principales: Nielsen, Nick S., Jespersen, Sofie, Gaardbo, Julie C., Arnbjerg, Caroline J., Clausen, Mette R., Kjær, Mette, Gerstoft, Jan, Ballegaard, Vibe, Ostrowski, Sisse R., Nielsen, Susanne D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454929/
https://www.ncbi.nlm.nih.gov/pubmed/28481325
http://dx.doi.org/10.3390/ijms18051016
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author Nielsen, Nick S.
Jespersen, Sofie
Gaardbo, Julie C.
Arnbjerg, Caroline J.
Clausen, Mette R.
Kjær, Mette
Gerstoft, Jan
Ballegaard, Vibe
Ostrowski, Sisse R.
Nielsen, Susanne D.
author_facet Nielsen, Nick S.
Jespersen, Sofie
Gaardbo, Julie C.
Arnbjerg, Caroline J.
Clausen, Mette R.
Kjær, Mette
Gerstoft, Jan
Ballegaard, Vibe
Ostrowski, Sisse R.
Nielsen, Susanne D.
author_sort Nielsen, Nick S.
collection PubMed
description Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies.
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spelling pubmed-54549292017-06-08 Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection Nielsen, Nick S. Jespersen, Sofie Gaardbo, Julie C. Arnbjerg, Caroline J. Clausen, Mette R. Kjær, Mette Gerstoft, Jan Ballegaard, Vibe Ostrowski, Sisse R. Nielsen, Susanne D. Int J Mol Sci Article Increased risk of both cardiovascular disease (CVD) and bleeding has been found in patients with chronic hepatitis C (CHC) infection, and a re-balanced hemostasis has been proposed. The aim of this study was to investigate functional whole blood coagulation and platelet function in CHC infection. The prospective study included 82 patients with CHC infection (39 with advanced liver fibrosis and 43 with no or mild liver fibrosis) and 39 healthy controls. A total of 33 patients were treated for CHC infection and achieved sustained virological response (SVR). Baseline and post-treatment blood samples were collected. Hemostasis was assessed by both standard coagulation tests and functional whole blood hemostatic assays (thromboelastograhy (TEG), and platelet aggregation (Multiplate). Patients with CHC and advanced fibrosis had impaired platelet aggregation both compared to patients with no or mild fibrosis and to healthy controls. Patients with CHC and advanced fibrosis also had lower antithrombin, platelet count, and coagulation factors II-VII-X compared to healthy controls. In contrast, TEG did not differ between groups. In treated patients achieving SVR, post-treatment platelet count was higher than pre-treatment counts (p = 0.033) and ADPtest, ASPItest, and RISTOhightest all increased post treatment (all p < 0.05). All Multiplate tests values, however, remained below those in the healthy controls. CHC-infected patients displayed evidence of rebalanced hemostasis with only partly hemostatic normalization in patients achieving SVR. The implications of rebalanced hemostasis and especially the impact on risk of CVD and bleeding warrants further studies. MDPI 2017-05-08 /pmc/articles/PMC5454929/ /pubmed/28481325 http://dx.doi.org/10.3390/ijms18051016 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nielsen, Nick S.
Jespersen, Sofie
Gaardbo, Julie C.
Arnbjerg, Caroline J.
Clausen, Mette R.
Kjær, Mette
Gerstoft, Jan
Ballegaard, Vibe
Ostrowski, Sisse R.
Nielsen, Susanne D.
Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title_full Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title_fullStr Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title_full_unstemmed Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title_short Impaired Platelet Aggregation and Rebalanced Hemostasis in Patients with Chronic Hepatitis C Virus Infection
title_sort impaired platelet aggregation and rebalanced hemostasis in patients with chronic hepatitis c virus infection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5454929/
https://www.ncbi.nlm.nih.gov/pubmed/28481325
http://dx.doi.org/10.3390/ijms18051016
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