Diabetic Platelet Reactivity Increases Cardiovascular Risk
Risk higher in patients with coronary artery disease on anti-platelet therapy
TUESDAY, Oct. 9 (HealthDay News) -- Patients with type 2 diabetes mellitus and coronary artery disease chronically treated with anti-platelet therapy are at higher risk of major cardiovascular events if they have high platelet reactivity, according to a report published online Oct. 1 in the Journal of the American College of Cardiology.
Dominick J. Angiolillo, M.D., Ph.D., from the University of Florida College of Medicine--Shands Jacksonville, and colleagues measured platelet activation and aggregation in 173 patients with type 2 diabetes and coronary artery disease who were on chronic treatment with aspirin and clopidogrel.
During two years of follow-up, there were 41 major adverse cardiovascular events in 34 patients (19.7 percent). High platelet reactivity was the strongest independent predictor of major adverse cardiovascular events, with a cutoff of 62 percent of maximal platelet aggregation being the best predictor (hazard ratio 3.35). Patients with high platelet reactivity had significantly increased activation of multiple platelet signaling pathways, according to the study.
"High platelet reactivity determined in type 2 diabetes mellitus patients with coronary artery disease while on chronic dual anti-platelet therapy is associated with a higher risk of long-term adverse cardiovascular events, suggesting the need for tailored anti-thrombotic drug regimens in these high-risk patients," Angiolillo and colleagues conclude.
Angiolillo is a speaker and consultant for Aventis, Bristol-Myers Squibb and Eli Lilly and has received an award sponsored by GlaxoSmithKline Research.