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. 2009 Nov;39(11):462-6.
doi: 10.4070/kcj.2009.39.11.462. Epub 2009 Nov 30.

Comparison of triple anti-platelet therapy (aspirin, clopidogrel, and cilostazol) and double anti-platelet therapy (aspirin and clopidogrel) on platelet aggregation in type 2 diabetic patients undergoing drug-eluting stent implantation

Tae-Hyun Yang  1 , Doo Il Kim, Jong Yoon Kim, Il Hwan Kim, Ki-Hun Kim, Yang Chun Han, Woong Kim, Sang Hoon Seol, Seong Man Kim, Dae Kyeong Kim, Dong Soo Kim
Affiliations

Comparison of triple anti-platelet therapy (aspirin, clopidogrel, and cilostazol) and double anti-platelet therapy (aspirin and clopidogrel) on platelet aggregation in type 2 diabetic patients undergoing drug-eluting stent implantation

Tae-Hyun Yang et al. Korean Circ J. 2009 Nov.

Abstract

Background and objectives: Triple anti-platelet therapy may produce more potent inhibition of platelet aggregation in patients undergoing coronary stent implantation. We tested whether this effect could be maintained in diabetic patients, where platelet reactivity is increased and the risk of stent thrombosis is higher.

Subjects and methods: Fifty five type 2 diabetic patients who had undergone drug-eluting stent (DES) implantation and chronic anti-platelet therapy (>1 month) were stratified according to the status of anti-platelet therapy. Platelet aggregation after adenosine diphosphate (ADP; 10 micromol/L and 20 micromol/L) stimulation was compared using light transmittance aggregometry between dual (aspirin plus clopidogrel, n=34) and triple therapy (aspirin, clopidogrel plus cilostazol, n=21) groups.

Results: The 2 groups had similar clinical and procedural characteristics. Maximal ADP-induced platelet aggregation was significantly lower in the triple therapy group than the dual therapy group (ADP 10 micromol/L, 37.1+/-15.4 vs. 28.3+/-11.8, p=0.03; ADP 20 micromol/L, 63.1+/-15.0 vs. 49.1+/-15.1, p=0.01), but there were no differences in diabetic treatment (oral hypoglycemic agent vs. insulin) or diabetic control {hemoglobin Alc (HbA1c) </=7 vs. HbA1c >7}.

Conclusion: Triple anti-platelet therapy showed more potent inhibition of maximal ADP induced platelet aggregation in type 2 diabetic patients receiving chronic anti-platelet therapy. This finding suggests that triple antiplatelet therapy may be more effective in preventing thrombotic complications after DES implantation in type 2 diabetic patients.

Keywords: Antiplatelet drugs; Diabetes mellitus; Platelet aggregation; Stents.

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Figures

Fig. 1
Fig. 1
Maximal platelet aggregation following ADP (10 and 20 µM) in type 2 diabetic patients according to anti-platelet drugs (Double, aspirin plus clopidogrel; Triple, aspirin, clopidogrel plus cilostazol). Numbers in the box denote the mean value of platelet aggregation. ADP: adenosine diphosphate.
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References

    1. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287:2570–2581. - PubMed
    1. Kim W, Jeong MH, Kim KH, et al. Long-term clinical and angiographic results of coronary stenting in diabetic patients. Korean Circ J. 2001;31:24–30.
    1. Iakovou I, Schmidt T, Bozizzoni E, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA. 2005;293:2126–2130. - PubMed
    1. Colwell JA, Nesto RW. The platelet in diabetes: focus on prevention of ischemic events. Diabetes Care. 2003;26:2181–2188. - PubMed
    1. Vinik AI, Erbas T, Park TS, Nolan R, Pittenger GL. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001;24:1476–1485. - PubMed