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Acta Diabetologica
Published in: Acta Diabetologica 4/2009

01-12-2009 | Review Article

Diabetes, vascular complications and antiplatelet therapy: open problems

Authors: A. M. Cerbone, N. Macarone-Palmieri, G. Saldalamacchia, A. Coppola, G. Di Minno, A. A. Rivellese

Published in: Acta Diabetologica | Issue 4/2009

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Abstract

Diabetes mellitus is commonly associated with both microvascular and macrovascular complications (coronary artery disease, cerebrovascular events, severe peripheral vascular disease, nephropathy and retinopathy). There is wide evidence demonstrating that platelet degranulation and synthesis of TxA2 are increased in diabetic patients. For this reason, many studies on anti-platelet therapy have been made to reduce thrombotic complication of diabetes mellitus. Some diabetic patients, although treated with ASA, have a high prevalence of recurrent thrombotic events, which may presumably be due to an “ASA resistance”. Nevertheless, this drug remains the one with the greatest benefit. To optimize its function, we should try to understand the causes of “aspirin resistance”, try to find the most suitable dosage, recommending patients to comply constantly with the prescription given and to avoid interactions with other drugs. “Clopidogrel resistance” is a term not clearly defined. The clinical implications of “clopidogrel resistance” are unknown. An important consideration affecting the use of aspirin in diabetic patients is its interaction with ACE-inhibitors. Another question is antiplatelet therapy in nephropathic diabetic patients. Although these patients are at high thrombotic and haemorrhagic risk, they should nevertheless be considered eligible to undergo antithrombotic therapy, taking into account the individual’s haemorrhagic risk.
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Metadata
Title
Diabetes, vascular complications and antiplatelet therapy: open problems
Authors
A. M. Cerbone
N. Macarone-Palmieri
G. Saldalamacchia
A. Coppola
G. Di Minno
A. A. Rivellese
Publication date
01-12-2009
Publisher
Springer Milan
Published in
Acta Diabetologica / Issue 4/2009
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI
https://doi.org/10.1007/s00592-008-0079-y

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