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

被引：23

作者：

Alexopoulos, Dimitrios ^{[1
]}

Vogiatzi, Chrysoula ^{[1
]}

Stavrou, Katerina ^{[1
]}

Vlassopoulou, Niki ^{[1
]}

Perperis, Angelos ^{[1
]}

Pentara, Ioanna ^{[1
]}

Xanthopoulou, Ioanna ^{[1
]}

机构：

[1] Univ Patras, Patras Univ Hosp, Dept Cardiol, Patras, Greece

来源：

CARDIOVASCULAR DIABETOLOGY | 2015年 / 14卷

关键词：

Antiplatelet agents; Antiplatelet drugs; Diabetes mellitus; Insulin; P2Y(12) purinergic receptors; PERCUTANEOUS CORONARY INTERVENTION; VERIFYNOW P2Y12 ASSAY; CARDIOVASCULAR OUTCOMES; ANTIPLATELET THERAPY; MAINTENANCE THERAPY; STENT THROMBOSIS; CLOPIDOGREL; INHIBITION; IMPACT; RESPONSIVENESS;

D O I：

10.1186/s12933-015-0232-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 P2Y(12) 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.

引用

页数：8

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