{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:14:09Z","timestamp":1787739249618,"version":"build-2784847793"},"reference-count":70,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Although platelets have been traditionally thought of to be essential hemostasis mediators, new research shows how important they are for controlling cellular oxidative stress, inflammatory processes, and immunological responses\u2014particularly during major surgery on the abdomen. Perioperative problems are largely caused by the continually changing interaction of inflammatory cytokines, the formation of reactive oxygen species (ROS), and platelet activation. The purpose of this review is to summarize the most recent data regarding the complex function of platelets in abdominal surgery, with an emphasis on how they interact with inflammation and oxidative stress, and to investigate the impact on postoperative therapy and subsequent studies. Recent study data on platelet biology, redox signals, surgical stress, and antiplatelet tactics was reviewed in a systematic manner. Novel tailored therapies, perioperative antiplatelet medication, oxidative biomarkers of interest, and platelet-derived microscopic particles are important themes. In surgical procedures, oxidative stress dramatically increases the reactive capacity of platelets, spurring thromboinflammatory processes that affect cardiac attacks, infection risk, and recovery. A number of biomarkers, including soluble CD40L, thromboxane B2, and sNOX2-derived peptide, showed potential in forecasting results and tailored treatment. Antiplatelet medications are still essential for controlling risk factors for cardiovascular disease, yet using them during surgery necessitates carefully weighing the risks of thrombosis and bleeding. Biomarker-guided therapies, antioxidant adjuncts, and specific platelet inhibitors are examples of evolving tactics. In abdominal procedures, platelets strategically operate at the nexus of oxidative stress, inflammatory processes, and clotting. Improved patient classification, fewer problems, and the creation of individualized surgical care strategies could result from an increased incorporation of platelet-focused tests and therapies into perioperative processes. To improve clinical recommendations, subsequent studies may want to focus on randomized studies, biomarker verification, and using translational approaches.<\/jats:p>","DOI":"10.3390\/ijms26157150","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T14:11:44Z","timestamp":1753366304000},"page":"7150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Systemic Impact of Platelet Activation in Abdominal Surgery: From Oxidative and Inflammatory Pathways to Postoperative Complications"],"prefix":"10.3390","volume":"26","author":[{"given":"Dragos-Viorel","family":"Scripcariu","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Huzum","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1981-8246","authenticated-orcid":false,"given":"Cornelia","family":"Mircea","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragos-Florin","family":"Tesoi","sequence":"additional","affiliation":[{"name":"Department of Pediatry, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana-Viola","family":"Badulescu","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1182\/bloodadvances.2019001414","article-title":"A practical approach to evaluating postoperative thrombocytopenia","volume":"4","author":"Skeith","year":"2020","journal-title":"Blood Adv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1080\/13510002.2021.1891808","article-title":"Contribution of oxidative stress in the mechanisms of postoperative complications and multiple organ dysfunction syndrome","volume":"26","author":"Rodrigo","year":"2021","journal-title":"Redox Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"889","DOI":"10.15537\/smj.2023.44.9.20230291","article-title":"Effect of platelet indices on postoperative pain and edema in bimaxillary surgery","volume":"44","author":"Yasli","year":"2023","journal-title":"Saudi Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"346","DOI":"10.2174\/187152810793938008","article-title":"Platelets and platelet-derived microparticles in vascular inflammatory disease","volume":"9","author":"Vasina","year":"2010","journal-title":"Inflamm. Allergy Drug Targets"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.3389\/fped.2020.00090","article-title":"Using Platelet Parameters to Anticipate Morbidity and Mortality Among Preterm Neonates: A Retrospective Study","volume":"8","author":"Go","year":"2020","journal-title":"Front. Pediatr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1080\/09537104.2019.1573977","article-title":"Preoperative platelet counts and postoperative outcomes in cancer surgery: A multicenter, retrospective cohort study","volume":"31","author":"Rachidi","year":"2019","journal-title":"Platelets"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1160\/THS10-11-0720","article-title":"Platelets, inflammation and tissue regeneration","volume":"105","author":"Nurden","year":"2011","journal-title":"Thromb. Haemost."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1038\/nri2956","article-title":"Platelets and the immune continuum","volume":"11","author":"Semple","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Masselli, E., Pozzi, G., Vaccarezza, M., Mirandola, P., Galli, D., Vitale, M., Carubbi, C., and Gobbi, G. (2020). ROS in Platelet Biology: Functional Aspects and Methodological Insights. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21144866"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"154463","DOI":"10.1016\/j.phymed.2022.154463","article-title":"Mechanism of platelet activation and potential therapeutic effects of natural drugs","volume":"108","author":"Zhou","year":"2023","journal-title":"Phytomedicine"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s13045-019-0709-6","article-title":"Platelet Integrin \u03b1IIb\u03b23: Signal transduction, regulation, and Its Therapeutic Targeting","volume":"12","author":"Huang","year":"2019","journal-title":"J. Hematol. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"6361","DOI":"10.3748\/wjg.v26.i41.6361","article-title":"P-selectin glycoprotein ligand 1 deficiency prevents development of acute pancreatitis by attenuating leukocyte infiltration","volume":"26","author":"Zhang","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3095","DOI":"10.1111\/jth.15496","article-title":"Proteome and functional decline as platelets age in the circulation","volume":"19","author":"Allan","year":"2021","journal-title":"J. Thromb. Haemost."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"118481","DOI":"10.1016\/j.lfs.2020.118481","article-title":"The G-protein \u03b2\u03b3 subunits regulate platelet function","volume":"262","author":"Alarabi","year":"2020","journal-title":"Life Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1161\/CIRCRESAHA.124.323067","article-title":"G Protein-Coupled Receptors: A Century of Research and Discovery","volume":"135","author":"Liu","year":"2024","journal-title":"Circ. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/j.1538-7836.2004.00556.x","article-title":"Gi-dependent and -independent mechanisms downstream of the P2Y12 ADP-receptor","volume":"2","author":"Soulet","year":"2004","journal-title":"J. Thromb. Haemost."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/ijlh.13866","article-title":"Update on platelet procoagulant mechanisms in health and in bleeding disorders","volume":"44","author":"Bourguignon","year":"2022","journal-title":"Int. J. Lab. Hematol."},{"key":"ref_18","first-page":"2675","article-title":"Targeting biased signaling by PAR1: Function and molecular mechanism of parmodulins","volume":"141","author":"Isermann","year":"2023","journal-title":"Blood"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"688643","DOI":"10.3389\/fimmu.2021.688643","article-title":"The Role of CLEC-2 and Its Ligands in Thromboinflammation","volume":"12","author":"Meng","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s12959-024-00594-8","article-title":"C-type lectin-like receptor 2: Roles and drug target","volume":"22","author":"Sun","year":"2024","journal-title":"Thromb. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1550","DOI":"10.1016\/j.jtha.2024.02.018","article-title":"Redox regulation of platelet function and thrombosis","volume":"22","author":"Jiang","year":"2024","journal-title":"J. Thromb. Haemost."},{"key":"ref_22","first-page":"100907","article-title":"Platelet-derived microparticles and their cargos: The past, present and future","volume":"19","author":"Guo","year":"2024","journal-title":"Asian J. Pharm. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1002\/JLB.2MR0220-549R","article-title":"ICAM-1: A master regulator of cellular responses in inflammation, injury resolution, and tumorigenesis","volume":"108","author":"Bui","year":"2020","journal-title":"J. Leukoc. Biol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Mandel, J., Casari, M., Stepanyan, M., Martyanov, A., and Deppermann, C. (2022). Beyond Hemostasis: Platelet Innate Immune Interactions and Thromboinflammation. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23073868"},{"key":"ref_25","first-page":"62","article-title":"Disorders of Thrombopoietin Synthesis in Viral Hepatitis and Its Complications, Some Changes in the Hemostasis System, and Their Diagnostics","volume":"5","author":"Kamolovna","year":"2025","journal-title":"Eur. J. Mod. Med. Pract."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1002\/hep.31698","article-title":"Efficiently Restored Thrombopoietin Production by Ashwell-Morell Receptor and IL-6R Induced Janus Kinase 2\/Signal Transducer and Activator of Transcription Signaling Early After Partial Hepatectomy","volume":"74","author":"Reusswig","year":"2021","journal-title":"Hepatology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"220","DOI":"10.13105\/wjma.v8.i3.220","article-title":"Thrombopoietin-receptor agonists in perioperative treatment of patients with chronic liver disease","volume":"8","author":"Qureshi","year":"2020","journal-title":"World J. Meta-Anal."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1016\/j.dld.2021.07.015","article-title":"Pre-procedural use of thrombopoietin-receptor agonists in cirrhosis and severe thrombocytopenia: A systematic review and meta-analysis","volume":"53","author":"Rose","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1182\/blood-2019-122609","article-title":"Perioperative Eltrombopag or Intravenous Immune Globulin for Patients with Immune Thrombocytopenia: A Multicenter Randomized Trial","volume":"134","author":"Arnold","year":"2019","journal-title":"Blood"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/j.bjae.2020.04.006","article-title":"Anaesthesia, analgesia, and the surgical stress response","volume":"20","author":"Cusack","year":"2020","journal-title":"BJA Educ."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"S\u00e1nchez-Infantes, D., Nus, M., Navas-Madro\u00f1al, M., Fit\u00e9, J., P\u00e9rez, B., Barros-Membrilla, A.J., Soto, B., Mart\u00ednez-Gonz\u00e1lez, J., Camacho, M., and Rodriguez, C. (2021). Oxidative Stress and Inflammatory Markers in Abdominal Aortic Aneurysm. Antioxidants, 10.","DOI":"10.3390\/antiox10040602"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e0185685","DOI":"10.1371\/journal.pone.0185685","article-title":"Inflammatory response and oxidative stress during liver resection","volume":"12","author":"Schwarz","year":"2017","journal-title":"PLoS ONE"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4540","DOI":"10.1245\/s10434-022-11412-8","article-title":"Oxidative Stress Predicts Post-Surgery Complications in Gastrointestinal Cancer Patients","volume":"29","author":"Bourgonje","year":"2022","journal-title":"Ann. Surg. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Zivkovic, A., Jotic, A., Dozic, I., Randjelovic, S., Cirkovic, I., Medic, B., Milovanovic, J., Trivi\u0107, A., Korugic, A., and Vukasinovi\u0107, I. (2024). Role of Oxidative Stress and Inflammation in Postoperative Complications and Quality of Life After Laryngeal Cancer Surgery. Cells, 13.","DOI":"10.3390\/cells13231951"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1450434","DOI":"10.3389\/fsurg.2024.1450434","article-title":"Enhancing recovery and reducing inflammation: The impact of enhanced recovery after surgery recommendations on inflammatory markers in laparoscopic surgery\u2014A scoping review","volume":"11","author":"Goncho","year":"2024","journal-title":"Front. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1182\/blood-2013-11-536003","article-title":"Platelet-TLR7 mediates host survival and platelet count during viral infection in the absence of platelet-dependent thrombosis","volume":"124","author":"Koupenova","year":"2014","journal-title":"Blood"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"649","DOI":"10.3389\/fimmu.2014.00649","article-title":"Platelets and infection\u2014An emerging role of platelets in viral infection","volume":"5","author":"Assinger","year":"2014","journal-title":"Front. Immunol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1161\/CIRCRESAHA.113.300512","article-title":"Platelets as Cellular Effectors of Inflammation in Vascular Diseases","volume":"112","author":"Rondina","year":"2013","journal-title":"Circ. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"85","DOI":"10.3389\/fcvm.2019.00085","article-title":"Platelet\u2013neutrophil interplay: Insights into neutrophil extracellular trap (NET)-driven coagulation in infection","volume":"6","author":"Zucoloto","year":"2019","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"678","DOI":"10.3389\/fimmu.2014.00678","article-title":"Platelets in inflammation: Regulation of leukocyte activities and vascular repair","volume":"5","author":"Gros","year":"2015","journal-title":"Front. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.1084\/jem.20170879","article-title":"Platelets as autonomous drones for hemostatic and immune surveillance","volume":"214","author":"Li","year":"2017","journal-title":"J. Exp. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1002\/rth2.12465","article-title":"The role of platelets in sepsis","volume":"5","author":"Shannon","year":"2020","journal-title":"Res. Pract. Thromb. Haemost."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Huang, M., Cai, S., and Su, J. (2019). The pathogenesis of sepsis and potential therapeutic targets. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20215376"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Ren, T., Mi, Y., Wei, J., Han, X., Zhang, X., Zhu, Q., Yue, T., Gao, W., Niu, X., and Han, C. (2024). Advances in Nano-Functional Materials in Targeted Thrombolytic Drug Delivery. Molecules, 29.","DOI":"10.3390\/molecules29102325"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Gutmann, C., Siow, R., Gwozdz, A.M., Saha, P., and Smith, A. (2020). Reactive Oxygen Species in Venous Thrombosis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21061918"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Saracoglu, A., and Tetik, S. (2018). Reactive Oxygen Species and their Interaction with Platelets. J. Med. Chem. Drug Des., 1.","DOI":"10.16966\/2578-9589.103"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Mladenov, M., Lubomirov, L., Grisk, O., Avtanski, D., Mitrokhin, V., Sazdova, I., Keremidarska-Markova, M., Danailova, Y., Nikolaev, G., and Konakchieva, R. (2023). Oxidative Stress, Reductive Stress and Antioxidants in Vascular Pathogenesis and Aging. Antioxidants, 12.","DOI":"10.3390\/antiox12051126"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1898844","DOI":"10.1155\/2022\/1898844","article-title":"Autophagy ameliorates ROS-induced platelet storage lesions","volume":"2022","author":"Zhao","year":"2022","journal-title":"Oxid. Med. Cell. Longev."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1111\/j.1399-6576.2011.02487.x","article-title":"Effect of L-carnitine on oxidative stress and platelet activation after major surgery","volume":"55","author":"Pignatelli","year":"2011","journal-title":"Acta Anaesthesiol. Scand."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.thromres.2016.01.006","article-title":"Role of platelets in cancer and cancer-associated thrombosis: Experimental and clinical evidences","volume":"139","author":"Mezouar","year":"2016","journal-title":"Thromb. Res."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Scopelliti, F., Cattani, C., Dimartino, V., Mirisola, C., and Cavani, A. (2022). Platelet Derivatives and the Immunomodulation of Wound Healing. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23158370"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Khelfi, A. (2024). Oxidative Stress in Inflammation. Biomarkers of Oxidative Stress, Springer.","DOI":"10.1007\/978-3-031-69962-7_2"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Huilcaman, R., Venturini, W., Fuenzalida, L., Cayo, A., Segovia, R., Valenzuela, C., Brown, N., and Moore-Carrasco, R. (2022). Platelets, a Key Cell in Inflammation and Atherosclerosis Progression. Cells, 11.","DOI":"10.3390\/cells11061014"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Hally, K., Fauteux-Daniel, S., Hamzeh-Cognasse, H., Larsen, P., and Cognasse, F. (2020). Revisiting Platelets and Toll-Like Receptors (TLRs): At the Interface of Vascular Immunity and Thrombosis. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21176150"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1016\/j.thromres.2014.08.009","article-title":"Platelet activation increases in patients undergoing vascular surgery","volume":"134","author":"Schneider","year":"2014","journal-title":"Thromb. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1016\/j.jacc.2021.01.015","article-title":"Platelet Reactivity in Patients with Acute Coronary Syndromes Awaiting Surgical Revascularization","volume":"77","author":"Nakashima","year":"2021","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2145","DOI":"10.1161\/CIRCULATIONAHA.118.035160","article-title":"Is There a Role for Preoperative Platelet Function Testing in Patients Undergoing Cardiac Surgery During Antiplatelet Therapy?","volume":"138","author":"Mahla","year":"2018","journal-title":"Circulation"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Pazoki, A., Dadfar, S., Shadab, A., Haghmorad, D., and Oksenych, V. (2024). Soluble CD40 Ligand as a Promising Biomarker in Cancer Diagnosis. Cells, 13.","DOI":"10.3390\/cells13151267"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"4084","DOI":"10.12998\/wjcc.v10.i13.4084","article-title":"High plasma CD40 ligand level is associated with more advanced stages and worse prognosis in colorectal cancer","volume":"10","author":"Herold","year":"2022","journal-title":"World J. Clin. Cases"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"749689","DOI":"10.3389\/fcell.2021.749689","article-title":"Pancreatic Cancer and Platelets Crosstalk: A Potential Biomarker and Target","volume":"9","author":"Mai","year":"2021","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1186\/s40364-025-00742-w","article-title":"The role of platelets in cancer: From their influence on tumor progression to their potential use in liquid biopsy","volume":"13","year":"2025","journal-title":"Biomark. Res."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"413","DOI":"10.4081\/oncol.2019.413","article-title":"Thrombocytopenia in solid tumors: Prognostic significance","volume":"13","author":"Ghanavat","year":"2019","journal-title":"Oncol. Rev."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Pereira-da-Silva, T., Napole\u00e3o, P., Pinheiro, T., Selas, M., Silva, F., Ferreira, R.C., and Carmo, M.M. (2021). The Proinflammatory Soluble CD40 Ligand Is Associated with the Systemic Extent of Stable Atherosclerosis. Medicina, 57.","DOI":"10.3390\/medicina57010039"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.freeradbiomed.2020.01.007","article-title":"Older adults with frailty syndrome present an altered platelet function and an increased level of circulating oxidative stress and mitochondrial dysfunction biomarker GDF-15","volume":"149","author":"Arauna","year":"2020","journal-title":"Free Radic. Biol. Med."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"5549","DOI":"10.1002\/ptr.8335","article-title":"Limitations and Challenges of Antioxidant Therapy","volume":"38","author":"Masoud","year":"2024","journal-title":"Phytother. Res."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e207","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline","volume":"162","author":"Douketis","year":"2022","journal-title":"Chest"},{"key":"ref_67","unstructured":"Polania Gutierrez, J.J., and Rocuts, K.R. (2025, July 03). Perioperative Anticoagulation Management, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK557590\/."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Lee, S.H., Lee, E.K., Ahn, H.J., Lee, S.M., Kim, J.A., Yang, M., Choi, J.W., Kim, J., Jeong, H., and Kim, S. (2023). Comparison of Early and Late Surgeries after Coronary Stent Implantation in Patients with Normal Preoperative Troponin Level: A Retrospective Study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072524"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.thromres.2011.12.002","article-title":"Platelet oxidative stress and thrombosis","volume":"129","author":"Violi","year":"2012","journal-title":"Thromb. Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"343","DOI":"10.2217\/14796678.2.3.343","article-title":"Antiplatelet therapy: Current strategies and future trends","volume":"2","author":"Tantry","year":"2006","journal-title":"Future Cardiol."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7150\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:15:28Z","timestamp":1760033728000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/15\/7150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,24]]},"references-count":70,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["ijms26157150"],"URL":"https:\/\/doi.org\/10.3390\/ijms26157150","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,24]]}}}