Evidence map›Paper›PMID 31910903›Full record

Trial reportCardiovascular diabetology2020

Aspirin, clopidogrel and prasugrel monotherapy in patients with type 2 diabetes mellitus: a double-blind randomised controlled trial of the effects on thrombotic markers and microRNA levels.

William A E Parker, Christian Schulte, Temo Barwari, Fladia Phoenix, Sam M Pearson, Manuel Mayr, Peter J Grant, Robert F Storey, Ramzi A Ajjan

Open access · goldAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Cardiovascular diabetology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed
5.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 40 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Review
  4. Article
  5. Article
  6. Review
  7. Review
  8. Review
  9. Article
  10. Review
  11. Review
  12. Review
  13. Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. PAR-4/CaCardiovascular diabetology · 2021
    Article
  19. Review
  20. MicroRNAs as Novel Biomarkers for P2Y12 - Inhibitors Resistance Prediction.Pharmacogenomics and personalized medicine · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

William A E ParkerDepartment of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK.ORCID 0000-0002-7822-8852
Christian SchulteKing's British Heart Foundation Centre, King's College London, London, UK.
Temo BarwariKing's British Heart Foundation Centre, King's College London, London, UK.
Fladia PhoenixLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Sam M PearsonLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Manuel MayrKing's British Heart Foundation Centre, King's College London, London, UK.
Peter J GrantLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
Robert F StoreyDepartment of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK.
Ramzi A AjjanLeeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK. R.Ajjan@leeds.ac.uk.
University of Leeds · GBKing's College London · GBUniversity of Sheffield · GBUniversität Hamburg · DE

Funding

British Heart Foundation CH/16/3/32406British Heart Foundation FS/18/49/33752British Heart Foundation RG/16/14/32397British Heart Foundation SP/17/10/33219
6 · The paper itself

Abstract

backgroundDespite increased atherothrombotic risk in type 2 diabetes mellitus, (T2DM) the best preventative antithrombotic strategy remains undetermined. We defined the effects of three antiplatelet agents on functional readout and biomarker kinetics in platelet activation and coagulation in patients with T2DM. MATERIALS AND

methods56 patients with T2DM were randomised to antiplatelet monotherapy with aspirin 75 mg once daily (OD), clopidogrel 75 mg OD or prasugrel 10 mg OD during three periods of a crossover study. Platelet aggregation (PA) was determined by light-transmittance aggregometry and P-selectin expression by flow cytometry. Markers of fibrin clot dynamics, inflammation and coagulation were measured. Plasma levels of 14 miRNA were assessed by quantitative polymerase chain reactions.

resultsOf the 56 patients, 24 (43%) were receiving aspirin for primary prevention of ischaemic events and 32 (57%) for secondary prevention. Prasugrel was the strongest inhibitor of ADP-induced PA (mean ± SD maximum response to 20μmol/L ADP 77.6 ± 8.4% [aspirin] vs. 57.7 ± 17.6% [clopidogrel] vs. 34.1 ± 14.1% [prasugrel], p < 0.001), P-selectin expression (30 μmol/L ADP; 45.1 ± 21.4% vs. 27.1 ± 19.0% vs. 14.1 ± 14.9%, p < 0.001) and collagen-induced PA (2 μg/mL; 62.1 ± 19.4% vs. 72.3 ± 18.2% vs. 60.2 ± 18.5%, p < 0.001). Fibrin clot dynamics and levels of coagulation and inflammatory proteins were similar. Lower levels of miR-24 (p = 0.004), miR-191 (p = 0.019), miR-197 (p = 0.009) and miR-223 (p = 0.014) were demonstrated during prasugrel-therapy vs. aspirin. Circulating miR-197 was lower in those cardiovascular disease during therapy with aspirin (p = 0.039) or prasugrel (p = 0.0083).

conclusionsPrasugrel monotherapy in T2DM provided potent platelet inhibition and reduced levels of a number of platelet-associated miRNAs. miR-197 is a potential marker of cardiovascular disease in this population. Clinical outcome studies investigating prasugrel monotherapy are warranted in individuals with T2DM. Trial registration EudraCT, 2009-011907-22. Registered 15 March 2010, https://www.clinicaltrialsregister.eu/ctr-search/trial/2009-011907-22/GB.

Indexed as

AgedAspirinBiomarkersBlood CoagulationClopidogrelCross-Over StudiesDiabetes Mellitus, Type 2Double-Blind MethodFemaleFibrinHumansMaleMicroRNAsMiddle AgedPlatelet AggregationPlatelet Aggregation InhibitorsAspirinBiomarkersClopidogrelFibrinMicroRNAsPlatelet Aggregation InhibitorsPrasugrel HydrochlorideP-SelectinSELP protein, humanAspirinDiabetes mellitusMicro RNAP2Y12 inhibitorsPlatelet inhibition

Identifiers

PMID31910903
PMCPMC6945631
OpenAlexW2999635443

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.