| Autor: |
Singam, Narayana Sarma V, AlAdili, Bahjat, Amraotkar, Alok R, Coulter, Amanda, Kulkarni, Siddhesh, Riten, Mitra, Defilippis, Andrew P, Daham, Omar N |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA14957-A14957, 1p |
| Abstrakt: |
Background:Patients with diabetes mellitus have more thrombotic complications and higher mortality than those without diabetes when presenting with a type-1 myocardial infarction (MI). CD40 ligand (CD40L) and platelet-monocyte aggregates (PMA) are in-vivo reporters of platelet activation and platelet aggregation, respectively. Ticagrelor is a direct P2Y12 platelet protein inhibitor that reduces mortality in MI. However, it is not known whether ticagrelor has a differential impact on in-vivo platelet activation and aggregation at the time of a type-1 MI in patients with and without diabetes.Hypothesis:We hypothesize that ticagrelor reduces platelet activation, as assessed by CD40L concentrations, equally among patients with and without diabetes during and after a type-1 MI, resulting in corresponding reductions in platelet aggregation as measured by PMA.Methods:Ninety-seven P2Y12 inhibitor na?ve patients (with diabetes, N=33 and without diabetes, N=64) were prospectively enrolled at the time of cardiac catheterization for a type-1 MI. Each patient received ticagrelor, and in-vivo measurements of CD40L and PMA were made at serial acute and a single follow-up time point(s). PMA is reported as a percentage of total monocyte population (percentage of monocytes bound to platelets). Analysis of variance between each time point and between the diabetic and nondiabetic cohorts was performed.Results:The concentration of CD40L decreased significantly (albeit transiently) after administration of ticagrelor, p<0.001 (Figure). PMA did not change over time and no significant difference in the CD40L or PMA concentration was observed between patients with and without diabetes (p>0.05 for all comparisons).Conclusion:In-vivo platelet activation assessed by CD40L and platelet aggregation assessed by PMA are not different between patients with and without diabetes mellitus after the administration ticagrelor at the time of and after an acute type-1 MI. |
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