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Effects of different doses of ticagrelor on platelet aggregation and endothelial function in diabetic patients with

Meijiao He1, Dan Li1, Yingli Zhang2

  • 1a Cardiovascular Department , the First Affiliated Hospital of Harbin Medical University , Harbin , Heilongjiang , P.R. China.

Platelets
|September 26, 2018
PubMed

Insights

Lower doses of ticagrelor effectively inhibit platelet aggregation in diabetic patients with coronary artery disease (CAD). Half-dose ticagrelor demonstrated superior endothelial protection and anti-inflammatory effects compared to clopidogrel.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Diabetic patients with stable coronary artery disease (CAD) often require antiplatelet therapy.
  • Ticagrelor and clopidogrel are commonly used P2Y12 inhibitors, but their optimal dosing in diabetic populations is under investigation.
  • Endothelial dysfunction and inflammation are key contributors to atherothrombosis in diabetes.

Purpose of the Study:

  • To evaluate the efficacy of different ticagrelor doses versus standard-dose clopidogrel on platelet reactivity and endothelial function.
  • To assess the impact of these treatments on inflammatory markers in type 2 diabetic patients with stable CAD.

Main Methods:

  • Sixty type 2 diabetic patients with stable CAD were randomized into four groups: one-quarter, half, and standard-dose ticagrelor, and standard-dose clopidogrel.
  • Platelet aggregation was measured using light transmission aggregometry (LTA) and VerifyNow assay.
  • Endothelial function was assessed via flow-mediated vasodilation (FMD), and plasma levels of von Willebrand factor (VWF), Interleukin-8 (IL-8), and IL-10 were quantified using ELISA.

Main Results:

  • All ticagrelor doses significantly reduced platelet aggregation compared to clopidogrel (P < 0.0001).
  • Half-dose and standard-dose ticagrelor showed significant reductions in IL-8 and IL-10 levels.
  • While FMD levels improved with ticagrelor and decreased with clopidogrel, no significant inter-group differences in FMD increase were observed. VWF levels decreased similarly across groups.

Conclusions:

  • One-quarter standard-dose ticagrelor achieved similar platelet inhibition to standard-dose clopidogrel.
  • Half-dose ticagrelor provided superior platelet inhibition, endothelial function protection, and anti-inflammatory effects compared to standard-dose clopidogrel in this diabetic CAD cohort.
  • Lower ticagrelor doses may offer a favorable balance of efficacy and safety in diabetic patients with stable CAD.

Keywords:
Coronary artery diseaseflow-mediated vasodilationinterleukinplatelet function teststicagrelorvon Willebrand factor

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