ArticleCardiovascular diabetology2015
The effect of clopidogrel on platelet activity in patients with and without type-2 diabetes mellitus: a comparative study.
Article in Cardiovascular diabetology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- Clinically important alterations in pharmacogene expression in histologically severe nonalcoholic fatty liver disease.Nature communications · 2023Pooled it
- The Use of Total Thrombus Formation Analysis System as a Tool to Assess Platelet Function in Bleeding and Thrombosis Risk-A Systematic Review.International journal of molecular sciences · 2021Pooled it
- Coronary artery bypass surgery compared with percutaneous coronary interventions in patients with insulin-treated type 2 diabetes mellitus: a systematic review and meta-analysis of 6 randomized controlled trials.Cardiovascular diabetology · 2016Pooled it
- Trial
- β-Amyloid and mitochondrial-derived peptide-c are additive predictors of adverse outcome to high-on-treatment platelet reactivity in type 2 diabetics with revascularized coronary artery disease.Journal of thrombosis and thrombolysis · 2020Trial
- PRotective Effect on the coronary microcirculation of patients with DIabetes by Clopidogrel or Ticagrelor (PREDICT): study rationale and design. A randomized multicenter clinical trial using intracoronary multimodal physiology.Cardiovascular diabetology · 2017Trial
- Association between insulin receptor substrate-1 polymorphisms and high platelet reactivity with clopidogrel therapy in coronary artery disease patients with type 2 diabetes mellitus.Cardiovascular diabetology · 2016Trial
- Prevalence of CYP2C19*2 and CYP2C19*3 Allelic Variants and Clopidogrel Use in Patients with Cardiovascular Disease in Trinidad & Tobago.Cardiology and therapy · 2024Article
- NT-proBNP and cardiovascular event risk in individuals with prediabetes undergoing cardiovascular evaluation.Diabetes research and clinical practice · 2023Article
- Impact of type 2 diabetes on in vivo activities and protein expressions of cytochrome P450 in patients with obesity.Clinical and translational science · 2022Article
- Disease Severity in Moderate-to-Severe COVID-19 Is Associated With Platelet Hyperreactivity and Innate Immune Activation.Frontiers in immunology · 2022Article
- Gene polymorphisms of insulin secretion signaling pathway associated with clopidogrel resistance in Han Chinese population.Journal of clinical laboratory analysis · 2021Article
- Prognostic value of subclinical myocardial necrosis using high-sensitivity cardiac troponin T in patients with prediabetes.Cardiovascular diabetology · 2021Article
- Chronic Inflammatory Status Observed in Patients with Type 2 Diabetes Induces Modulation of Cytochrome P450 Expression and Activity.International journal of molecular sciences · 2021Review
- Illustrative and historic cases of phenoconversion.American journal of translational research · 2021Review
- Ticagrelor and prasugrel are independent predictors of improved long-term survival in ACS patients.European journal of clinical investigation · 2020Observational
- Long-term effect of clopidogrel in patients with and without diabetes: A systematic review and meta-analysis of randomized controlled trials.World journal of diabetes · 2020Article
- Factors associated with platelet reactivity during dual antiplatelet therapy in patients with diabetes after acute coronary syndrome.Scientific reports · 2020Article
- Vascular miR-181b controls tissue factor-dependent thrombogenicity and inflammation in type 2 diabetes.Cardiovascular diabetology · 2020Article
- Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough antiplatelet therapy involving clopidogrel is a standard treatment for preventing cardiovascular events after coronary stent implantation, patients can display differential responses. Here, we assessed the effectiveness of clopidogrel on platelet function inhibition in subjects with and without type-2 diabetes and stable coronary artery disease. In addition, we investigated the correlation between platelet function and routine clinical parameters.
methodsA total of 64 patients with stable coronary heart disease were enrolled in the study. Among these, 32 had known type-2 diabetes, whereas the remaining 32 subjects were non-diabetics (control group). A loading dose of 300 mg clopidogrel was given to clopidogrel-naïve patients (13 patients in the diabetes group and 14 control patients). All patients were given a daily maintenance dose of 75 mg clopidogrel. In addition, all patients received 100 mg ASA per day. Agonist-induced platelet aggregation measurements were performed on hirudin-anticoagulated blood using an impedance aggregometer (Multiple Platelet Function Analyzer, Dynabyte, Munich, Germany). Blood samples were drawn from the antecubital vein 24 h after coronary angiography with percutaneous coronary intervention. The platelets were then stimulated with ADP alone or ADP and prostaglandin-E (ADP and ADP-PGE tests, respectively) in order to evaluate clopidogrel-mediated inhibition of platelet function. The effectiveness of ASA was measured by stimulation with arachidonic acid (ASPI test). In addition, maximal platelet aggregation was assessed via stimulation with thrombin receptor-activating peptide (TRAP test).
resultsPatients with diabetes exhibited significantly less inhibition of platelet function than patients without diabetes (ADP-PGE test p = 0.003; ASPI test p = 0.022). Administering a clopidogrel loading dose of 300 mg did not result in a lower level of ADP-PGE-induced platelet reactivity in comparison to the use of a 75 mg maintenance dose. Moreover, we observed that ADP-PGE-induced platelet inhibition was positively correlated with fasting blood glucose and HbA1c (p < 0.01).
conclusionsPatients with type-2 diabetes exhibited increased platelet reactivity compared to patients without diabetes despite combined treatment with clopidogrel and ASA. Using a loading dose of clopidogrel rather than small daily doses was not sufficient for adequately overcoming increased platelet reactivity in patients with type-2 diabetes, highlighting the need for more effective anti-platelet drugs for such patients.
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