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Cardiovascular Diabetology
Published in: Cardiovascular Diabetology 1/2015

Open Access 01-12-2015 | Original investigation

Diabetes mellitus and platelet reactivity in patients under prasugrel or ticagrelor treatment: an observational study

Authors: Dimitrios Alexopoulos, Chrysoula Vogiatzi, Katerina Stavrou, Niki Vlassopoulou, Angelos Perperis, Ioanna Pentara, Ioanna Xanthopoulou

Published in: Cardiovascular Diabetology | Issue 1/2015

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Abstract

Background

The influence of diabetes mellitus (DM) on platelet reactivity (PR) in prasugrel or ticagrelor treated patients is not well studied.

Methods

In an observational study involving 777 patients with acute coronary syndrome undergoing percutaneous coronary intervention treated by either prasugrel 10 mg od (n = 315) or ticagrelor 90 mg bid (n = 462), platelet function was assessed using the VerifyNow P2Y12 function assay (in PRU) at one month post intervention.

Results

In the overall population, ticagrelor and insulin-treated DM affected PR, with a decrease in log by 0.88 (corresponding to a 58 % decrease in PR) compared to prasugrel-treated patients (p < 0.001), and an increase in log by 0.26 (corresponding to a 30 % increase in PR) compared to non-diabetic patients (p = 0.01), respectively. PR in prasugrel-treated patients differed significantly by DM status: 70.0 (36.3-113.0) in non-diabetic vs 69.0 (44.5-115.3) in non insulin-treated diabetic vs 122.0 (69.0-161.0) in insulin-treated diabetic patients, p for trend = 0.01. No differences were observed in ticagrelor-treated patients. By multivariate analysis, in prasugrel-treated patients insulin-treated DM was the only factor predicting PR, with log of PR increased by 0.42 (corresponding to a 52 % increase in PR) compared to non-diabetic patients (p = 0.001). No factor was found to affect PR in ticagrelor-treated patients.

Conclusions

Patients with insulin-treated DM treated with prasugrel post PCI have higher PR, than patients without DM or non insulin-treated diabetic patients treated with this drug. Ticagrelor treated patients have overall lower PR than patients on prasugrel, independent of DM status or insulin treatment.

Trial registration

Clinical Trials Gov. NCT01774955
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Metadata
Title
Diabetes mellitus and platelet reactivity in patients under prasugrel or ticagrelor treatment: an observational study
Authors
Dimitrios Alexopoulos
Chrysoula Vogiatzi
Katerina Stavrou
Niki Vlassopoulou
Angelos Perperis
Ioanna Pentara
Ioanna Xanthopoulou
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2015
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/s12933-015-0232-1

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