INTRODUCTION: Diabetes mellitus is complicated by accelerated atherosclerosis, resulting in an increased risk of coronary artery disease (CAD) and thrombosis. Despite the proven benefits of aspirin, previous studies indicate a reduced cardiovascular protection from aspirin in diabetic patients. We aimed to investigate whether diabetes mellitus influenced the platelet response to aspirin in patients with CAD. MATERIALS AND METHODS: Platelet aggregation and activation were evaluated during aspirin treatment in 85 diabetic and 92 non-diabetic patients with CAD. Adherence to aspirin was carefully controlled. All patients had CAD verified by coronary angiography and were taking 75 mg non-enteric coated aspirin daily. RESULTS: Diabetic patients showed significantly higher levels of platelet aggregation compared to non-diabetic patients evaluated by VerifyNow® Aspirin (p=0.03) and Multiplate® aggregometry using arachidonic acid (AA) 0.5 mM (p=0.005) and 1.0 mM (p=0.009). In addition, platelet activation determined by soluble P-selectin was significantly higher in diabetics compared to non-diabetics (p=0.005). The higher AA-induced aggregation was associated with higher levels of HbA(1c). Compliance was confirmed by low levels of serum thromboxane B(2) (below 7.2 ng/mL). Diabetics had significantly higher levels of serum thromboxane B(2) (p<0.0001). CONCLUSIONS: Diabetic patients with CAD had significantly higher levels of both platelet aggregation and activation compared to non-diabetic patients with CAD despite treatment with the same dosage of aspirin. These findings may partly explain the reduced cardiovascular protection from aspirin in diabetic patients.
INTRODUCTION:Diabetes mellitus is complicated by accelerated atherosclerosis, resulting in an increased risk of coronary artery disease (CAD) and thrombosis. Despite the proven benefits of aspirin, previous studies indicate a reduced cardiovascular protection from aspirin in diabeticpatients. We aimed to investigate whether diabetes mellitus influenced the platelet response to aspirin in patients with CAD. MATERIALS AND METHODS:Platelet aggregation and activation were evaluated during aspirin treatment in 85 diabetic and 92 non-diabeticpatients with CAD. Adherence to aspirin was carefully controlled. All patients had CAD verified by coronary angiography and were taking 75 mg non-enteric coated aspirin daily. RESULTS:Diabeticpatients showed significantly higher levels of platelet aggregation compared to non-diabeticpatients evaluated by VerifyNow® Aspirin (p=0.03) and Multiplate® aggregometry using arachidonic acid (AA) 0.5 mM (p=0.005) and 1.0 mM (p=0.009). In addition, platelet activation determined by soluble P-selectin was significantly higher in diabetics compared to non-diabetics (p=0.005). The higher AA-induced aggregation was associated with higher levels of HbA(1c). Compliance was confirmed by low levels of serum thromboxane B(2) (below 7.2 ng/mL). Diabetics had significantly higher levels of serum thromboxane B(2) (p<0.0001). CONCLUSIONS:Diabeticpatients with CAD had significantly higher levels of both platelet aggregation and activation compared to non-diabeticpatients with CAD despite treatment with the same dosage of aspirin. These findings may partly explain the reduced cardiovascular protection from aspirin in diabeticpatients.
Authors: Marek Postula; Piotr K Janicki; Marek Rosiak; Agnieszka Kaplon-Cieslicka; Ewa Trzepla; Krzysztof J Filipiak; Dariusz A Kosior; Andrzej Czlonkowski; Grzegorz Opolski Journal: J Thromb Thrombolysis Date: 2013-07 Impact factor: 2.300
Authors: Rakesh K Sharma; Stephen W Erickson; Rohit Sharma; Donald J Voelker; Hanumanth K Reddy; Harvinder Dod; James D Marsh Journal: Vasc Health Risk Manag Date: 2013-05-01
Authors: Marek Postula; Piotr K Janicki; Marek Rosiak; Agnieszka Kaplon-Cieslicka; Agnieszka Kondracka; Ewa Trzepla; Krzysztof J Filipiak; Dariusz A Kosior; Andrzej Czlonkowski; Grzegorz Opolski Journal: Med Sci Monit Date: 2013-05-27