TY - JOUR
T1 - Effect of glycemic control on response to antiplatelet therapy in patients with diabetes mellitus and ST-segment elevation myocardial infarction
AU - Kuliczkowski, Wiktor
AU - Gasior, Mariusz
AU - Pres, Damian
AU - Kaczmarski, Jacek
AU - Greif, Małgorzata
AU - Łaszewska, Anna
AU - Szewczyk, Marta
AU - Hawranek, Michal
AU - Tajstra, Mateusz
AU - Zegleń, Sławomir
AU - Poloski, Lech
AU - Serebruany, Victor
PY - 2012/8/1
Y1 - 2012/8/1
N2 - Impaired glycemic control (GC) is a troubling clinical condition with an unclear prognostic value that is frequent in diabetics, especially in the setting of acute coronary syndrome. Residual platelet reactivity can be also affected by GC. We evaluated the relation between response to dual antiplatelet therapy and GC in diabetics with STEMI treated with primary coronary angioplasty (PCI). Sixty diabetic patients were prospectively enrolled in the study. All patients were treated with clopidogrel and aspirin. Platelet reactivity (whole blood aggregation and phosphorylation of vasodilator-stimulated phosphoprotein, VASP) were assessed serially before and 24 hours, 7 days, and 30 days after the PCI. Blood glucose >8.5 mmol/L on admission was an independent predictor of a impaired clopidogrel response measured with platelet reactivity index (PRI) >50% on admission (OR 7.8, 95% CI 1.4-17.7, p8.5 mmol/L on admission is related to a poorer response to clopidogrel. There were no interaction between glycated hemoglobin level or glycemia on admission and platelet reactivity measured with collagen, arachidonic acid or thrombin receptor agonist peptide-induced aggregation. Further clinical studies of the role of GC in the efficacy of antiplatelet agents are warranted.
AB - Impaired glycemic control (GC) is a troubling clinical condition with an unclear prognostic value that is frequent in diabetics, especially in the setting of acute coronary syndrome. Residual platelet reactivity can be also affected by GC. We evaluated the relation between response to dual antiplatelet therapy and GC in diabetics with STEMI treated with primary coronary angioplasty (PCI). Sixty diabetic patients were prospectively enrolled in the study. All patients were treated with clopidogrel and aspirin. Platelet reactivity (whole blood aggregation and phosphorylation of vasodilator-stimulated phosphoprotein, VASP) were assessed serially before and 24 hours, 7 days, and 30 days after the PCI. Blood glucose >8.5 mmol/L on admission was an independent predictor of a impaired clopidogrel response measured with platelet reactivity index (PRI) >50% on admission (OR 7.8, 95% CI 1.4-17.7, p8.5 mmol/L on admission is related to a poorer response to clopidogrel. There were no interaction between glycated hemoglobin level or glycemia on admission and platelet reactivity measured with collagen, arachidonic acid or thrombin receptor agonist peptide-induced aggregation. Further clinical studies of the role of GC in the efficacy of antiplatelet agents are warranted.
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U2 - 10.1016/j.amjcard.2012.03.027
DO - 10.1016/j.amjcard.2012.03.027
M3 - Article
C2 - 22551736
AN - SCOPUS:84863986937
VL - 110
SP - 331
EP - 336
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 3
ER -