Effect of glycemic control on response to antiplatelet therapy in patients with diabetes mellitus and ST-segment elevation myocardial infarction
| Autor: | Victor L. Serebruany, Małgorzata Greif, Marta Szewczyk, Mariusz Gąsior, Lech Poloński, S. Żegleń, Wiktor Kuliczkowski, Michał Hawranek, Mateusz Tajstra, Jacek Kaczmarski, Anna Łaszewska, Damian Pres |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Acute coronary syndrome Ticlopidine Diabetic Cardiomyopathies Myocardial Infarction chemistry.chemical_compound Electrocardiography Internal medicine Diabetes mellitus Medicine Humans cardiovascular diseases Myocardial infarction Prospective Studies Angioplasty Balloon Coronary Glycemic Aspirin business.industry Middle Aged medicine.disease Clopidogrel chemistry Conventional PCI Cardiology Female Glycated hemoglobin Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | The American journal of cardiology. 110(3) |
| ISSN: | 1879-1913 |
| Popis: | 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 glucose8.5 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, p0.02) and 24 hours after PCI (OR 13.1, 95% CI 3.4-28.1, p0.01). In conclusion, diabetic patients with STEMI and glycemia8.5 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect