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  2. Palavra-chave: Thrombosis
IJCS
Review Article

The Role of Platelets in Long COVID Development: A Literature Review

Gabriel Ferreira Lima et al. Lucas Miossi Amanda Gonçalves Jesus Silva Olivia Barros Pedreira Novais Fernanda Carla Ferreira Brito

Abstract

At its peak during the pandemic, coronavirus disease 2019 profoundly impacted global populations and introduced numerous post-infection complications, collectively referred to as long coronavirus disease. The mechanisms underlying the syndrome’s chronicity are multifaceted; however, a notable aspect of long coronavirus disease pathophysiology is its intricate association with platelets. The chronic inflammatory response triggered by severe acute respiratory syndrome coronavirus 2 is closely related to platelet activity, wherein inflammatory molecules bind to specific platelet receptors, inducing the release of platelet granules containing procoagulant and proinflammatory molecules. Consequently, there is a marked elevation in coagulation-related proteins, fostering the development of abnormal microthrombi and a dysfunctional fibrinolytic system. All these changes are indicative of an imbalance in coagulation regulation. Therefore, investigating pharmacological targets linked to this process is crucial for syndrome management, aiming to enhance the quality of life for affected individuals. This review aimed to highlight the importance of platelet function and activity in the pathophysiology of long coronavirus disease, as well as to identify molecular targets directly related to long coronavirus disease or coronavirus disease 2019–related disturbances in platelet homeostasis.

  • Blood Platelets
  • Inflammation
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
01/06/2026 DOI: 10.36660/ijcs.20240189
IJCS
Editorial

Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?

Humberto Villacorta

Heart failure (HF) is an aggressive disease with unfavorable prognosis if not treated properly. Even after optimal medical treatment, some patients may remain at high risk for clinical events. As such, it is important to identify patients at risk of death or hospitalization. Biomarkers have been used to establish prognosis in HF, and natriuretic peptides (NP) are considered the gold standard biomarker in HF, not only for diagnosis but also for prognosis.

NP are cardiac biomarkers, produced by the heart ventricles in response to wall stretch. However, several systemic biomarkers, reflecting different pathways, have been shown to be elevated in HF with the potential to add information on top of NP ().– Nevertheless, these biomarkers have not been strongly recommended in HF guidelines because their utility in aiding decision-making is unclear.

[…]

  • Biomarkers
  • Heart Failure
  • Infections
  • Prognosis
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
27/06/2025 DOI: 10.36660/ijcs.20250084
IJCS
Original Article

The Association Between IL-4 Expression and Thrombus Events in Rheumatic Heart Disease Patients

Arini Rizky Wijayanti et al. Dyah Samti Mayasari Erika Maharani Hasanah Mumpuni … Sofia Pranacipta Emilia Theresia Nungki Anggorowati Ery Kus Dwianingsih

Abstract

Background:

Rheumatic heart disease (RHD) is the leading cause of valve disease in developing countries, with intracardiac thrombus events as one of the frequent manifestations. Based on Trias Virchow, a thrombus occurs because of endothelial injury, blood flow abnormality, and hypercoagulability. In RHD, this condition is caused by inflammation, mitral stenosis (MS), and atrial fibrillation (AF). Pro-inflammatory cytokines promote thrombus formation, and anti-inflammatory cytokines inhibit it. IL-4 is an anti-inflammatory cytokine that can potentially inhibit thrombus formation because it can inhibit other pro-inflammatory cytokines and polarize M2 macrophages.

Objectives:

This study aims to know the association of IL-4 expression with thrombus events in RHD patients.

Methods:

Twenty-five (25) patients enrolled in this study were diagnosed with RHD and underwent mitral valve replacement surgery. Valve tissues were collected for histopathological and immunohistochemical examination using IL-4. Thrombus event obtained from echocardiography result. The Mann-Whitney test was used to compare IL-4 expression in thrombus and non-thrombus patients. A p-value of less than 0.05 (p<0.05) was considered the significance level.

Results:

Of the 25 patients, 88% were older than 30 years. Thrombus occurs in 28% of RHD patients and is associated with AF (p 0.001). Patients with moderate and high IL-4 expression did not have less thrombus than patients with low IL-4 expression.

Conclusions:

Intracardiac thrombus formation in RHD patients is not associated with IL-4 expression but is strongly associated with AF. Further research that identifies other cytokines coexisting with IL-4 at the site of injury may reveal better insight into the event.

  • Atrial Fibrillation
  • Interleukin-4
  • Rheumatic Heart Disease
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
02/12/2024 DOI: 10.36660/ijcs.20240109 Visualizações 2
IJCS
Editorial

Rivaroxaban: is it Really Need to Monitor its Anticoagulant Effect in Clinical Practice?

Luiz Eduardo Montenegro Camanho et al. Gustavo Vignoli dos Santos

Oral anticoagulation (OAC) has been the cornerstone for the treatment of atrial fibrillation (AF) patients. The vitamin K antagonist warfarin has been considered the drug of choice in stroke prevention with proven efficacy for more than 60 years. The great inter-patient and intra-patient dose variability and need for routine International Normalized Ratio (INR), are among the main disadvantages of warfarin. The direct-acting oral anticoagulants (DOACs), including direct thrombin inhibitors (dabigatran) and factors Xa inhibitors (apixaban, edoxaban, and rivaroxaban), are currently the therapy of choice for preventing thromboembolic events in patients with atrial fibrillation. Unlike warfarin and other vitamin K antagonists, the DOACs are administered in fixed doses and do not require routine laboratory monitoring.

Rivaroxaban is an oral inhibitor of free and clot-associated factor Xa through reversible, competitive interactions with its active site. Bioavailability following oral administration is dose-dependent, and it is highly bound to plasma proteins. Plasma levels peak 2 to 4 h following oral administration, partially excreted by the kidneys, and has a half-life depending on the dose and age. Factor Xa inhibitors variably affect prothrombin time (PT), with concentration-dependent PT prolongation. The sensitivity of the different assays varies widely, depending on the thromboplastin reagent, and it is recommended to check the sensitivity of PT in each institution. At therapeutic doses, rivaroxaban has a relatively weak effect on PT, but there is a more pronounced effect on supratherapeutic doses.

[…]

  • Anticoagulants
  • Atrial Fibrillation
  • Pulmonary Embolism
  • Rivaroxaban/therapeutic use
  • Stroke
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
12/03/2021 DOI: 10.36660/ijcs.20200373
IJCS
Editorial

Association between the Average Ratio of Platelet Volume and the Presence of Mural Thrombus in Post-Myocardial Infarction

Fernando Augusto Alves da Costa

Cardiovascular disease is a serious public health problem, responsible for 31% of all deaths worldwide. Population growth, urbanization and the lack of proper policies to control modifiable risk factors lead to an increased number in cases. Associated with this, we have new factors such as stress, pollution, income, unemployment, among others, which, associated with classical factors, increase the speed of atherosclerosis development. Acute ischemic syndromes are some of the worst consequences of the evolution of atherosclerosis, with mortality rates varying according to the type of infarction, place of care and the healthcare resources available.

Among the types of infarction, those with ST segment elevation (STEMI), particularly in the anterior wall, present peculiarities in their natural history, and may lead to complications, such as sudden death, heart failure and embolic events, usually due to the formation of apical thrombus (AT) in the left ventricle.

[…]

  • Atherosclerosis
  • Cardiovascular Diseases/prevention and control
  • Mortality
  • Public Health Program
  • Risk Factors
  • ST Elevation Myocardial Infarction
  • stress
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
09/10/2020 DOI: 10.36660/ijcs.20200263 Visualizações 1
ABC
Original Article

Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results

Auristela I. O. Ramos et al. Rui F. Ramos Dorival J. D. Togna Antoninho S. Arnoni … Rodolfo Staico Mercedes M. Galo Zilda M. Meneghelo

OBJECTIVE: To assess the short- and long-term results of the use of streptokinase (SK) for the treatment of thromboses in cardiac valvular prostheses. METHODS: Seventeen patients with cardiac prosthetic thrombosis diagnosed by clinical, echocardiographic, and radioscopic findings underwent fibrinolytic treatment with a streptokinase bolus of 250,000 U followed by 100.000 U/hour. Short- and long-term results were assessed by radioscopy and echocardiography. RESULTS: Of the 17 patients, 12 had mechanical double-disk prostheses (4 aortic, 6 mitral, 2 tricuspid), 4 had single-disk prostheses (2 aortic, 1 mitral, and 1 tricuspid), and 1 had a tricuspid bioprosthesis. The success rate was 64.8%, the partial success rate was 17.6%, and the nonsuccess rate was 17.6%. All patients with a double-disk prosthesis responded, completely or partially, to the treatment. None of the patients with a single-disk prosthesis had complete resolution of the thrombosis. The time of streptokinase infusion ranged from 6 to 80 hours (mean of 56 h). The mortality rate due to the use of streptokinase was 5.8% and was secondary to cerebral bleeding. During streptokinase infusion, 3 (17.6%) embolic episodes occurred as follows: 1 cerebral, 1 peripheral, and 1 coronary. The rethrombosis index was 33% in a mean follow-up of 42 months. CONCLUSION: The use of fibrinolytic agents was effective and relatively safe in patients with primary thrombosis of a double-disk prosthesis. A fatal hemorrhagic complication occurred in 1 (5.8%) patient, and embolic complications occurred in 3 (17.6%) patients. In a mean 42-month follow-up, 67% of the patients were free from rethrombosis.

  • cardiac valvular prostheses
  • fibrinolytic therapy
  • streptokinase
  • Thrombosis
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Creative Commons Attribution (CC BY) Creative Commons license
05/11/2003 DOI: 10.1590/S0066-782X2003001200006

Como citar este artigo

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Lima GF, Miossi L, Silva AGJ, Novais OBP, Brito FCF. The Role of Platelets in Long COVID Development: A Literature Review. International Journal of Cardiovascular Sciences 2026;39:e20240189.

Formato de Documento Eletrônico (ABNT)

Lima, Gabriel Ferreira; Miossi, Lucas; Silva, Amanda Gonçalves Jesus; Novais, Olivia Barros Pedreira; Brito, Fernanda Carla Ferreira. The Role of Platelets in Long COVID Development: A Literature Review. International Journal of Cardiovascular Sciences, v. 39, e20240189, maio. 2026.

Formato de Documento Eletrônico (APA)

Lima, G. F., Miossi, L., Silva, A. G. J., Novais, O. B. P., & Brito, F. C. F. (2026). The Role of Platelets in Long COVID Development: A Literature Review. International Journal of Cardiovascular Sciences, 39, e20240189.

Formato de Documento Eletrônico (ISO)

Lima, Gabriel Ferreira and Miossi, Lucas and Silva, Amanda Gonçalves Jesus and Novais, Olivia Barros Pedreira and Brito, Fernanda Carla Ferreira. The Role of Platelets in Long COVID Development: A Literature Review. International Journal of Cardiovascular Sciences [online]. 2026, vol. 39, [citado 2026-10-14], e20240189. Disponível em: <https://journals.cardiol.br/article/the-role-of-platelets-in-long-covid-development-a-literature-review-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Villacorta H. Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?. International Journal of Cardiovascular Sciences 2025;38:e20250084.

Formato de Documento Eletrônico (ABNT)

Villacorta, Humberto. Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?. International Journal of Cardiovascular Sciences, v. 38, e20250084, jun. 2025.

Formato de Documento Eletrônico (APA)

Villacorta, H. (2025). Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?. International Journal of Cardiovascular Sciences, 38, e20250084.

Formato de Documento Eletrônico (ISO)

Villacorta, Humberto. Systemic Biomarkers in Heart Failure: To Measure or Not to Measure?. International Journal of Cardiovascular Sciences [online]. 2025, vol. 38, [citado 2026-10-14], e20250084. Disponível em: <https://journals.cardiol.br/article/systemic-biomarkers-in-heart-failure-to-measure-or-not-to-measure-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Wijayanti AR, Mayasari DS, Maharani E, Mumpuni H, Pranacipta S, Theresia E, Anggorowati N, et al. The Association Between IL-4 Expression and Thrombus Events in Rheumatic Heart Disease Patients. International Journal of Cardiovascular Sciences 2024;37:e20240109.

Formato de Documento Eletrônico (ABNT)

Wijayanti, Arini Rizky; Mayasari, Dyah Samti; Maharani, Erika; Mumpuni, Hasanah; Pranacipta, Sofia; Theresia, Emilia; Anggorowati, Nungki; Dwianingsih, Ery Kus. The Association Between IL-4 Expression and Thrombus Events in Rheumatic Heart Disease Patients. International Journal of Cardiovascular Sciences, v. 37, e20240109, dez. 2024.

Formato de Documento Eletrônico (APA)

Wijayanti, A. R., Mayasari, D. S., Maharani, E., Mumpuni, H., Pranacipta, S., Theresia, E., Anggorowati, N., & Dwianingsih, E. K. (2024). The Association Between IL-4 Expression and Thrombus Events in Rheumatic Heart Disease Patients. International Journal of Cardiovascular Sciences, 37, e20240109.

Formato de Documento Eletrônico (ISO)

Wijayanti, Arini Rizky and Mayasari, Dyah Samti and Maharani, Erika and Mumpuni, Hasanah and Pranacipta, Sofia and Theresia, Emilia and Anggorowati, Nungki and Dwianingsih, Ery Kus. The Association Between IL-4 Expression and Thrombus Events in Rheumatic Heart Disease Patients. International Journal of Cardiovascular Sciences [online]. 2024, vol. 37, [citado 2026-10-14], e20240109. Disponível em: <https://journals.cardiol.br/article/the-association-between-il-4-expression-and-thrombus-events-in-rheumatic-heart-disease-patients-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Camanho LEM, Santos GV. Rivaroxaban: is it Really Need to Monitor its Anticoagulant Effect in Clinical Practice?. International Journal of Cardiovascular Sciences 2021;34(2):122-3.

Formato de Documento Eletrônico (ABNT)

Camanho, Luiz Eduardo Montenegro; Santos, Gustavo Vignoli dos. Rivaroxaban: is it Really Need to Monitor its Anticoagulant Effect in Clinical Practice?. International Journal of Cardiovascular Sciences, v. 34, n. 2, p. 122-123, mar. 2021.

Formato de Documento Eletrônico (APA)

Camanho, L. E. M., & Santos, G. V. (2021). Rivaroxaban: is it Really Need to Monitor its Anticoagulant Effect in Clinical Practice?. International Journal of Cardiovascular Sciences, 34(2), 122-123.

Formato de Documento Eletrônico (ISO)

Camanho, Luiz Eduardo Montenegro and Santos, Gustavo Vignoli dos. Rivaroxaban: is it Really Need to Monitor its Anticoagulant Effect in Clinical Practice?. International Journal of Cardiovascular Sciences [online]. 2021, vol. 34, n. 2, [citado 2026-10-14], pp. 122-123. Disponível em: <https://journals.cardiol.br/article/rivaroxaban-is-it-really-need-to-monitor-its-anticoagulant-effect-in-clinical-practice-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Costa FAA. Association between the Average Ratio of Platelet Volume and the Presence of Mural Thrombus in Post-Myocardial Infarction. International Journal of Cardiovascular Sciences 2020;33(5):516-7.

Formato de Documento Eletrônico (ABNT)

Costa, Fernando Augusto Alves da. Association between the Average Ratio of Platelet Volume and the Presence of Mural Thrombus in Post-Myocardial Infarction. International Journal of Cardiovascular Sciences, v. 33, n. 5, p. 516-517, out. 2020.

Formato de Documento Eletrônico (APA)

Costa, F. A. A. (2020). Association between the Average Ratio of Platelet Volume and the Presence of Mural Thrombus in Post-Myocardial Infarction. International Journal of Cardiovascular Sciences, 33(5), 516-517.

Formato de Documento Eletrônico (ISO)

Costa, Fernando Augusto Alves da. Association between the Average Ratio of Platelet Volume and the Presence of Mural Thrombus in Post-Myocardial Infarction. International Journal of Cardiovascular Sciences [online]. 2020, vol. 33, n. 5, [citado 2026-10-14], pp. 516-517. Disponível em: <https://journals.cardiol.br/article/association-between-the-average-ratio-of-platelet-volume-and-the-presence-of-mural-thrombus-in-post-myocardial-infarction-2/>. ISSN 2359-4802

EndNote RIS

Formato de Documento Eletrônico (Vancouver)

Ramos AIO, Ramos RF, Togna DJD, Arnoni AS, Staico R, Galo MM, Meneghelo ZM, et al. Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results. Arquivos Brasileiros de Cardiologia 2003;81(4):393-8.

Formato de Documento Eletrônico (ABNT)

Ramos, Auristela I. O.; Ramos, Rui F.; Togna, Dorival J. D.; Arnoni, Antoninho S.; Staico, Rodolfo; Galo, Mercedes M.; Meneghelo, Zilda M.. Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results. Arquivos Brasileiros de Cardiologia, v. 81, n. 4, p. 393-398, nov. 2003.

Formato de Documento Eletrônico (APA)

Ramos, A. I. O., Ramos, R. F., Togna, D. J. D., Arnoni, A. S., Staico, R., Galo, M. M., & Meneghelo, Z. M. (2003). Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results. Arquivos Brasileiros de Cardiologia, 81(4), 393-398.

Formato de Documento Eletrônico (ISO)

Ramos, Auristela I. O. and Ramos, Rui F. and Togna, Dorival J. D. and Arnoni, Antoninho S. and Staico, Rodolfo and Galo, Mercedes M. and Meneghelo, Zilda M.. Fibrinolytic therapy for thrombosis in cardiac valvular prosthesis short and long term results. Arquivos Brasileiros de Cardiologia [online]. 2003, vol. 81, n. 4, [citado 2026-10-14], pp. 393-398. Disponível em: <https://journals.cardiol.br/article/fibrinolytic-therapy-for-thrombosis-in-cardiac-valvular-prosthesis-short-and-long-term-results-2/>. ISSN 0066-782X

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