The relation between platelet reactivity and glycemic control in diabetic patients with cardiovascular disease on maintenance aspirin and clopidogrel therapy

• Published in: The American heart journal 2009-11, Vol.158 (5), p.784.e1-784.e6
• Main Authors: Singla, Anand, MD, Antonino, Mark J., BS, Bliden, Kevin P., BS, Tantry, Udaya S., PhD, Gurbel, Paul A., MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aspirin; Aspirin - pharmacology; Blood Glucose; Blood platelets; Blood Platelets - drug effects; Body mass index; Cardiovascular; Cardiovascular disease; Cardiovascular Diseases - blood; Coronary vessels; Diabetes; Diabetes Mellitus, Type 2; Diabetic Angiopathies - blood; Drug dosages; Drug therapy; Drug Therapy, Combination; Family medical history; Female; Hospitals; Humans; Hypertension; Male; Middle Aged; Platelet Aggregation - drug effects; Platelet Aggregation Inhibitors - pharmacology; Studies; Ticlopidine - analogs & derivatives; Ticlopidine - pharmacology; Treatment Outcome
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2009.08.013

Background High platelet reactivity (HPR) during aspirin and clopidogrel therapy in patients with diabetes has been reported and may affect outcomes. However, the relation of platelet reactivity to glycemic control is less studied in patients on dual antiplatelet therapy. Methods Platelet aggregation (PA) in response to 5 and 20 μmol/L adenosine diphosphate (ADP) was compared in type 2 diabetic (n = 36) and nondiabetic patients (n = 35) undergoing elective stenting on aspirin and clopidogrel maintenance therapy. The relation of glycosylated hemoglobin (HbA1c ) 46% for 5 μmol/L ADP-induced and >59% for 20 μmol/L ADP-induced PA. Results Diabetic patients had higher 5 and 20 μmol/L ADP-induced PA than nondiabetic patients (45 ± 17 vs 33 ± 12, P = .009 and 52 ± 19 vs 40 ± 12, P = .004, respectively). Diabetic patients with HbA1c ≥7.0 g/dL had significantly higher 5 and 20 μmol/L ADP-induced PA versus patients with diabetes with HbA1c