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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Diabetes, vascular complications and antiplatelet therapy: open problems
A M Cerbone1, N Macarone-Palmieri, G Saldalamacchia
1Department of Clinical and Experimental Medicine, "Federico II" University Hospital, Via S. Pansini 5 Edificio 1, 80131, Naples, Italy. ancerbon@unina.it
Acta Diabetologica
|December 3, 2008
Summary
Diabetic patients often experience thrombotic events despite aspirin therapy, possibly due to aspirin resistance. Optimizing aspirin use involves understanding resistance, correct dosage, adherence, and avoiding drug interactions.
Area of Science:
- Cardiology
- Endocrinology
- Pharmacology
Background:
- Diabetes mellitus is linked to microvascular and macrovascular complications, including cardiovascular events.
- Diabetic patients exhibit increased platelet activity and thromboxane A2 (TxA2) synthesis, raising thrombotic risk.
- Anti-platelet therapies are crucial for mitigating thrombotic complications in diabetes.
Purpose of the Study:
- To explore the phenomenon of aspirin resistance in diabetic patients.
- To discuss strategies for optimizing aspirin efficacy in diabetes management.
- To review anti-platelet therapy considerations in diabetic nephropathy.
Main Methods:
- Review of existing evidence on platelet function in diabetes.
- Analysis of studies investigating anti-platelet therapy outcomes in diabetic populations.
- Examination of drug interactions and patient adherence factors.
Main Results:
- Aspirin (ASA) remains beneficial, but "ASA resistance" may explain recurrent thrombotic events in some diabetic patients.
- The definition and clinical impact of "clopidogrel resistance" are not well-established.
- Aspirin's interaction with ACE-inhibitors and its use in nephropathic patients require careful consideration.
Conclusions:
- Understanding and addressing aspirin resistance is key to improving anti-platelet therapy effectiveness in diabetes.
- Careful patient management, including adherence and drug interaction awareness, is vital.
- Diabetic patients with nephropathy warrant individualized antithrombotic therapy assessments, balancing thrombotic and hemorrhagic risks.
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