Sex-specific predictive value of reticulated platelets in coronary artery disease: A systematic review and meta-analysis.

IF 4.4 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Clinical Investigation Pub Date : 2025-05-19 DOI:10.1111/eci.70078

Sebastien Elvinger, Stephanie G Kuehne, Andrea Patrignani, Maximilian Tscharre, Matthias Freynhofer, Leor Perl, Ran Kornowski, Francesca Cesari, Rossella Marcucci, Laura Novelli, Isabell Bernlochner, Philip W Raake, Mauro Chiarito, Dario Bongiovanni

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引用次数: 0

Abstract

Background: Platelets play a crucial role in immune responses and haemostasis. Among them, reticulated platelets (RPs) have gathered attention for their association with prothrombotic states and as a potential biomarker for cardiovascular events. However, the sex-specific prognostic value of RPs remains underexplored.

Objective: This study aimed to systematically review and analyse sex-specific differences in the prognostic role of RPs in cardiovascular disease.

Methods: We conducted a comprehensive search on studies that reported patient outcomes related to RPs. Study authors were contacted to provide sex-specific patient-level data. Two studies were excluded due to data unavailability. The primary endpoint was major adverse cardiovascular and cerebrovascular events (MACCE). Secondary endpoints included cardiovascular death, myocardial infarction, stroke, urgent revascularization, and bleeding incidents. All outcomes were stratified by sex.

Results: The analysis included 5 studies, reporting outcomes in 1835 patients (527 females and 1308 males). RPs are a significant predictor of MACCE independently of sex males (OR 1.99 [95% CI 1.3, 3.05; I² = 29%]), females (2.29 [95% CI 1.31, 3.99; I² = 10%]). For cardiovascular death RPs were predictive in females (OR 3.29 [95% CI 1.69, 6.40] I² = .83%) and showed a trend toward significance in males (OR 2.19 95% CI [.98, 4.9] I² = 42.72%). No sex-specific differences were observed in all other secondary endpoints.

Conclusion: RPs significantly predict MACCE in cardiovascular disease independently from sex and may have a stronger association with cardiovascular death in females. Further research is needed to explore the sex-specific mechanisms of RPs' prognostic value.

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网状血小板在冠状动脉疾病中的性别特异性预测价值：一项系统综述和荟萃分析

背景：血小板在免疫反应和止血中起着至关重要的作用。其中，网状血小板（RPs）因其与血栓形成前状态的关联以及作为心血管事件的潜在生物标志物而受到关注。然而，RPs的性别特异性预后价值仍未得到充分探讨。目的：本研究旨在系统回顾和分析RPs在心血管疾病预后中的性别差异。方法：我们对报道与rp相关的患者结果的研究进行了全面的检索。研究人员联系了研究作者，以提供按性别区分的患者水平数据。两项研究因数据不可得而被排除。主要终点是主要心脑血管不良事件（MACCE）。次要终点包括心血管死亡、心肌梗死、中风、紧急血运重建术和出血事件。所有结果按性别分层。结果：纳入5项研究，报告了1835例患者（女性527例，男性1308例）的结果。RPs是独立于性别男性的MACCE的重要预测因子(OR 1.99 [95% CI 1.3, 3.05；I2 = 29%])，女性(2.29 [95% CI 1.31, 3.99；i2 = 10%])。对于心血管死亡，RPs在女性中具有预测意义（OR 3.29 [95% CI 1.69, 6.40] I2 = 0.83%），在男性中具有显著性趋势(OR 2.19 95% CI[。[98, 4.9] i2 = 42.72%)。在所有其他次要终点均未观察到性别特异性差异。结论：RPs可以独立于性别显著预测心血管疾病的MACCE，并且可能与女性心血管死亡有更强的关联。需要进一步的研究来探索RPs的预后价值的性别特异性机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Clinical Investigation 医学-医学：内科

CiteScore

9.50

自引率

3.60%

发文量

192

审稿时长

1 months

期刊介绍： EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.