Abstract:
INTRODUCTION:Type 2 diabetes mellitus (T2DM) patients have a variable response profile to the P2Y(12) receptor antagonist clopidogrel. P2Y(12) receptor signalling promotes platelet procoagulant activity. The aim of this study was to determine if T2DM patients with suboptimal clopidogrel response have greater platelet procoagulant activity compared with optimal responders and evaluate if this can be modulated by enhancing P2Y(12) receptor inhibition. MATERIALS AND METHODS:A total of 50 T2DM patients in a steady state phase of clopidogrel therapy were studied. Suboptimal responders were randomly assigned to standard (75 mg) or high (150 mg) clopidogrel maintenance therapy for one-month. Afterwards, all patients resumed standard therapy. Platelet procoagulant activity assessed by thrombin-induced platelet-fibrin clot formation using thrombelastography (TEG) was determined at baseline, one-month post-randomization, and one-month after resuming standard therapy. RESULTS:In the overall study population, the reaction time (R), a measure of time to initial thrombin induced platelet-fibrin clot formation, and the time to maximum rate of thrombin generation (TMRTG) values were 6.3+/-1.7 and 7.6+/-1.9 minutes, respectively. Suboptimal clopidogrel responders (n=30) had acceleration of R (p=0.002) and TMRTG (p=0.002) compared to optimal responders (n=20). Suboptimal clopidogrel responders treated with a 150 mg dose showed prolongation of R (p=0.0001) and TMRTG (p<0.0001), which returned to baseline values after resuming standard dosage. No differences were observed among patients randomized to 75 mg. CONCLUSIONS:T2DM patients with suboptimal clopidogrel response have enhanced platelet procoagulant activity compared to patients with optimal response, which can be down-regulated by more potent platelet P2Y(12) inhibition using high clopidogrel maintenance dosing.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Angiolillo DJ,Capranzano P,Desai B,Shoemaker SB,Charlton R,Zenni MM,Guzman LA,Bass TAdoi
10.1016/j.thromres.2008.10.001subject
Has Abstractpub_date
2009-07-01 00:00:00pages
318-22issue
3eissn
0049-3848issn
1879-2472pii
S0049-3848(08)00453-2journal_volume
124pub_type
杂志文章abstract:INTRODUCTION:High concentrations of N-terminal-pro-brain natriuretic peptide (NT-proBNP) are found in patients with right ventricular overload. Right ventricular overload may be the result of large perfusion defects in patients with pulmonary embolism (PE). NT-proBNP levels are associated with poorer outcome in patient...
journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2011-06-01 00:00:00
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更新日期:2015-02-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(82)90308-5
更新日期:1982-09-01 00:00:00
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更新日期:1990-03-15 00:00:00
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doi:10.1016/0049-3848(90)90335-a
更新日期:1990-10-01 00:00:00
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doi:10.1016/j.thromres.2017.11.016
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
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更新日期:2006-01-01 00:00:00
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pub_type: 杂志文章,实务指引
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pub_type: 杂志文章
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更新日期:2013-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:1985-11-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(82)90032-9
更新日期:1982-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0049-3848(90)90053-f
更新日期:1990-08-15 00:00:00
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pub_type: 杂志文章
doi:10.1016/s0049-3848(03)00288-3
更新日期:2003-04-15 00:00:00
abstract::Plasma antithrombin III (AT-III) levels were measured in 61 patients undergoing general surgery. The patients were randomly allocated to a test or a control group. The test group received 5000iu of subcutaneous heparin two hours before operation and then twelve hourly for seven days. The control group received subcuta...
journal_title:Thrombosis research
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0049-3848(86)90102-7
更新日期:1986-09-15 00:00:00
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pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2008.10.003
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更新日期:2012-11-01 00:00:00
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更新日期:1983-12-15 00:00:00
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pub_type: 杂志文章
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更新日期:2007-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(86)90133-7
更新日期:1986-10-15 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-05-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2000-06-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2016-04-01 00:00:00
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pub_type: 杂志文章
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2014.01.034
更新日期:2014-04-01 00:00:00
abstract::Platelet aggregate size was determined with a newly-developed platelet aggregometer, PA-100 (KOWA), which can quantitatively evaluate the size and number of platelet aggregates by means of the particle counting method based upon light scattering. Epinephrine-induced platelet aggregation consists of two phases, the for...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(96)00026-6
更新日期:1996-03-01 00:00:00
abstract:INTRODUCTION:Pelvic deep vein thrombosis (DVT) is difficult to diagnose during pregnancy. In a two-center trial, we evaluated the agreement between ultrasonography and magnetic resonance imaging (MRI) in diagnosing the extent of DVT into the pelvic veins during pregnancy. MATERIALS AND METHODS:Pregnant women with prox...
journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2010-08-01 00:00:00