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Thromb Haemost
DOI: 10.1055/a-2747-8963
Original Article: Cellular Haemostasis and Platelets

Occurrence of Platelet–Monocyte Aggregates in Patients with Metabolic Disorders and Effect of Direct Anticoagulants

Authors

  • Catherine Gunaseelan

    1   Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Zuzana Lomozová

    2   Department of Pharmacognosy and Pharmaceutical Botany, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Marcel Hrubša

    1   Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Markéta Pacliková

    3   3rd Department of Internal Medicine–Metabolic Care and Gerontology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Pavel Skořepa

    3   3rd Department of Internal Medicine–Metabolic Care and Gerontology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czechia
    4   Department of Military Internal Medicine and Military Hygiene, Military Faculty of Medicine, University of Defence, Hradec Kralove, Czechia

  • Kateřina Matoušová

    5   The Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czechia

  • Dorota Turonová

    5   The Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czechia

  • Lenka Kujovská Krcmová

    5   The Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, Hradec Králové, Czechia
    6   Department Analytical Chemistry, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Milan Bláha

    3   3rd Department of Internal Medicine–Metabolic Care and Gerontology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Vladimír Blaha

    3   3rd Department of Internal Medicine–Metabolic Care and Gerontology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Přemysl Mladěnka 

    1   Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

  • Alejandro Carazo 

    1   Department of Pharmacology and Toxicology, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czechia

Funding Information This work was supported by the Czech Health Research Council (grant no. NU21J-02–00021); Charles University (PRIMUS/25/MED/001 and SVV 260 549) and MH CZ - DRO (grant no. UHHK, 00179906).
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Graphical Abstract

Abstract

Background

Platelet–monocyte aggregates (PMA) are modern biomarkers for the early onset of cardiovascular diseases (CVD). PMA occur in the presence of activated platelets (AP), whose incidence is higher in patients with metabolic diseases. These patients frequently benefit from anticoagulant therapy, particularly in advanced disease stages. However, the impact of these drugs on PMA occurrence is unknown.

Materials and Methods

Blood samples from healthy volunteers, patients with type 1 diabetes mellitus (DMT1), type 2 diabetes mellitus (DMT2), dyslipidemia (hypercholesterolemia), and severe forms of familial hypercholesterolemia (FH) were analyzed by flow cytometry to detect both AP and PMA. Subsequently, blood samples were treated with four direct anticoagulants (rivaroxaban, apixaban, dabigatran, or argatroban, all at a final concentration of 1 µM), and PMA were again detected. Anthropological and biochemical parameters were recorded and correlated with AP and PMA.

Results

AP levels were higher solely in DMT2 patients, but PMA occurrence was significantly increased in all patient groups in comparison to that of generally healthy donors, except for FH patients. No sex-related differences were observed, but an increasing trend in AP and PMA incidence was observed with increasing age and BMI. Significant correlations of AP and PMA with anthropological and biochemical parameters were found solely in some groups of patients or in some anticoagulant-treated samples. Only argatroban and apixaban-treated samples significantly decreased PMA occurrence, and this was observed solely in the dyslipidemia patient group.

Conclusion

These findings suggest a potential positive outcome of anticoagulant treatment for metabolic disease patients and confirm PMA as a sensitive marker in patients with metabolic diseases.

Keywords

platelet–monocyte aggregates - metabolic disorders - activated platelets - anticoagulants

Data Availability Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request. Some data may not be made available because of privacy or ethical restrictions.


Contributors' Statement

C.G. contributed to investigation, formal analysis, writing—original draft; Z.L. contributed to investigation, writing—review and editing; M.H. contributed to investigation, writing—review and editing; M.P. contributed to investigation, writing—review and editing; P.S. contributed to investigation, writing—review and editing, funding acquisition; K.M. contributed to investigation, writing—review and editing; D.T. contributed to investigation, writing—review and editing; L.K.K. contributed to investigation, writing—review and editing, funding acquisition, supervision; M.B. contributed to methodology, supervision, writing—review and editing; V.B. contributed to methodology, supervision, writing—review and editing; P.M. contributed to conceptualization, methodology, formal analysis, writing—original draft, writing—review and editing, funding acquisition, supervision; A.C. contributed to conceptualization, methodology, investigation, formal analysis, writing—review and editing, funding acquisition, supervision. All authors read and approved the submitted version of the manuscript.


Ethical Approval

This study was approved by the Ethics Committee of the University Hospital in Hradec Králové (No. 202007 S01P from June 18, 2020). All experiments conformed to the latest Declaration of Helsinki.


Supplementary Material



Publication History

Received: 07 May 2025

Accepted after revision: 13 November 2025

Article published online:
05 December 2025

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