Background: About 40% of clopidogrel-treated patients display high platelet reactivity (HPR). Alternative treatments of HPR patients, identified by platelet function tests, failed to improve their clinical outcomes in large randomized clinical trials. A more appealing alternative would be to identify HPR patients a priori, based on the presence/absence of demographic, clinical and genetic factors that affect PR. Due to the complexity and multiplicity of these factors, traditional statistical methods (TSMs) fail to identify a priori HPR patients accurately. The objective was to test whether Artificial Neural Networks (ANNs) or other Machine Learning Systems (MLSs), which use algorithms to extract model-like 'structure' information from a given set of data, accurately predict platelet reactivity (PR) in clopidogrel-treated patients.
Methods: A complete set of fifty-nine demographic, clinical, genetic data was available of 603 patients with acute coronary syndromes enrolled in the prospective GEPRESS study, which showed that HPR after 1month of clopidogrel treatment independently predicted adverse cardiovascular events in patients with Syntax Score >14. Data were analysed by MLSs and TSMs. ANNs identified more variables associated PR at 1month, compared to TSMs.
Results: ANNs overall accuracy in predicting PR, although superior to other MLSs was 63% (95% CI 59-66). PR phenotype changed in both directions in 35% of patients across the 3 time points tested (before PCI, at hospital discharge and at 1month).
Conclusions: Despite their ability to analyse very complex non-linear phenomena, ANNs or MLS were unable to predict PR accurately, likely because PR is a highly unstable phenotype.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.ijcard.2017.03.074 | DOI Listing |
Naunyn Schmiedebergs Arch Pharmacol
January 2025
Department of Dermatology, Dongshan Hospital, Guofengyuan Building, Xuezi Avenue, Meijiang District, Meizhou, 514011, Guangdong, China.
Platelet-rich plasma (PRP) holds promising prospects for the treatment of skin photoaging. This study aims to unravel the mechanism underlying PRP's anti-photoaging properties. Partial skin of rats was irradiated with ultraviolet (UV) and injected with PRP, and the skin appearance, pathological state, and aging conditions were determined.
View Article and Find Full Text PDFInfect Drug Resist
January 2025
Department of Infectious Disease, Changzheng Hospital, Navy Medical University, Shanghai, People's Republic of China.
The Hepatorenal Syndrome-Acute Kidney Injury (HRS-AKI) patients infected with methicillin-resistant (MRSA) urgently require safe and effective treatment options due to their compromised hepatic and renal functions, as well as thrombocytopenia resulting from hypersplenism. In our case, an HRS-AKI patient who underwent continuous renal replacement therapy for fluid overload developed fever with chills. His blood tests indicated elevated C-reactive protein and neutrophils, low platelet count, and bilateral lung infiltrates.
View Article and Find Full Text PDFJ Psychiatr Res
January 2025
Department of Psychiatry, Bakirkoy Prof Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkiye.
Objective: Evaluation of the effects of electroconvulsive therapy (ECT) on systemic inflammatory markers in patients with severe mental disorders and determination of potential clinical predictors of treatment response.
Methods: The current retrospective cohort study included 156 patients with psychotic and mood disorders who underwent ECT. Pre- and post-ECT blood samples were collected to assess inflammatory markers, including C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), and other complete blood count derived indices.
Proteomics Clin Appl
January 2025
SPHERE Research Group, Conway Institute, University College Dublin, Dublin, Ireland.
Purpose: Multiple Sclerosis is an inflammatory neurodegenerative disease characterised by blood-brain barrier dysfunction and leukocyte infiltration into the CNS. Platelets are best known for their contributions to haemostasis, however, upon activation, platelets release an abundance of soluble and vesicular-associated proteins, termed the platelet releasate (PR). This milieu contains numerous inflammatory and vasoactive proteins, that can attract leukocytes and alter endothelial permeability.
View Article and Find Full Text PDFZh Nevrol Psikhiatr Im S S Korsakova
January 2025
Pirogov City Clinical Hospital No. 1, Moscow, Russia.
Objective: To study the associations of genetic markers influencing the residual reactivity of platelets during antiplatelet therapy with acetylsalicylic acid, and clinical and laboratory parameters, including parameters of the platelet hemostasis, in patients with non-cardioembolic ischemic stroke (IS) for a deeper understanding of the pathogenetic mechanisms and prediction of response to therapy and clinical outcome.
Material And Methods: The study included 296 patients (average age 64.65 [55; 76] years) undergoing treatment at the City Clinical Hospital named after.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!