What is the clinical evidence from this study?

Study design: Case-Control. Population: Diabetes mellitus (n=77). Intervention: Diabetes mellitus vs. Matched controls. Primary outcome: Arachidonic acid induced aggregation and TxB2 production (p=<0.01).

What does this research mean for the field?

Platelets from diabetic patients produce normal amounts of thromboxane B2 in vitro when physiological ionized calcium concentrations are maintained, showing that previously reported in vitro increases are an artifact of citrate anticoagulation. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

January 1, 1993Thrombosis and Haemostasis

The In Vitro Production of Thromboxane B2 by Platelets of Diabetic Patients Is Normal at Physiological Concentrations of lonized Calcium

Q: What are the key findings of this study?

Platelets from diabetic patients produced normal amounts of thromboxane B2 in vitro when physiological ionized calcium concentrations were maintained, unlike the artifactual increases seen in citrated plasma.

Q: What does this research mean for the field?

Platelets from diabetic patients produce normal amounts of thromboxane B2 in vitro when physiological ionized calcium concentrations are maintained, showing that previously reported in vitro increases are an artifact of citrate anticoagulation. Novelty: ClaimNovelty.CONTRADICTORY. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

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Key result

Maintaining physiological calcium prevents artifactual increases in diabetic platelet TxB2 production seen with citrated plasma.

P<0.01
n=77

Why the study?

Platelets of diabetic patients show increased thromboxane B2 production in vitro under low ionized calcium conditions, contrasting with normal in vivo production, suggesting a need to clarify the effect of physiological ionized calcium on thromboxane B2 production.

Does maintaining physiological ionized calcium concentrations in vitro normalize thromboxane B2 production by platelets from diabetic patients compared to controls?

Comparison

PPACK anticoagulation (physiological ionized calcium) vs citrate anticoagulation (low ionized calcium) in vitro

Design

Case-control study

Authors

CFC FalcónUniversity of Milan MCMarco CattaneoVascular Medicine AGAlberto GhidoniUniversity of Milan

Discussion

Member takes

Implication

Cautions against citrated plasma assays for diabetic platelet studies; challenges prior hyperreactivity reports and leaves open physiological calcium effects on clinical risk.

Study Design

Type

Case-Control (n=77)

Structured PICO

Does maintaining physiological ionized calcium concentrations in vitro normalize thromboxane B2 production by platelets from diabetic patients compared to controls?

Population

77 participants including 40 patients with diabetes mellitus and 37 matched controls.

Exposure

In vitro blood anticoagulation with the thrombin inhibitor D-phenylalanyl-l-prolyl-l-chloromethylketone (PPACK) to maintain physiological ionized calcium concentrations

Comparator

In vitro blood anticoagulation with citrate (low ionized calcium) and matched non-diabetic controls

Outcome

Platelet aggregation, release of 14C-serotonin, and thromboxane (Tx) B2 production induced by agonists in platelet rich plasma (PRP)surrogate

Main Result

p-value: p=<0.01

The apparent in vitro hyperreactivity and increased thromboxane B2 production of diabetic platelets is an artifact caused by low ionized calcium in citrated plasma, and normalizes at physiological calcium concentrations.

Cite This Study

Falcón et al. (1993) conducted a case-control in Diabetes mellitus (n=77). Diabetes mellitus vs. Matched controls was evaluated on Arachidonic acid induced aggregation and TxB2 production (p=<0.01). Platelets from diabetic patients produced normal amounts of thromboxane B2 in vitro when physiological ionized calcium concentrations were maintained, unlike the artifactual increases seen in citrated plasma.

synapsesocial.com/papers/6aaa4c3b9ee2cf6512136a98 https://doi.org/10.1055/s-0038-1649591

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Implication

Cautions against citrated plasma assays for diabetic platelet studies; challenges prior hyperreactivity reports and leaves open physiological calcium effects on clinical risk.

The In Vitro Production of Thromboxane B2 by Platelets of Diabetic Patients Is Normal at Physiological Concentrations of lonized Calcium

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

The In Vitro Production of Thromboxane B2 by Platelets of Diabetic Patients Is Normal at Physiological Concentrations of lonized Calcium

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider