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Interaction Between Diabetes Mellitus and Platelet Reactivity in Determining Long-Term Outcomes Following

Fabio Mangiacapra1, Edoardo Bressi2, Iginio Colaiori2

  • 1Unit of Cardiovascular Science, Department of Medicine, Campus Bio-Medico University, Via Álvaro del Portillo,, 200-00128, Rome, Italy. f.mangiacapra@unicampus.it.

Journal of Cardiovascular Translational Research
|November 17, 2019
PubMed

Insights

Patients with diabetes mellitus (DM) and high platelet reactivity (HPR) face significantly higher risks of major adverse clinical events (MACE) after percutaneous coronary intervention (PCI). This combination identifies a high-risk group needing closer monitoring.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Diabetes mellitus (DM) is a known risk factor for poor outcomes in patients with coronary artery disease (CAD).
  • High platelet reactivity (HPR) is associated with adverse events after percutaneous coronary intervention (PCI).
  • The combined impact of DM and HPR on long-term outcomes post-PCI requires further investigation.

Purpose of the Study:

  • To examine the interaction between DM and HPR in predicting long-term clinical outcomes following PCI.
  • To identify patient subgroups at elevated risk for major adverse clinical events (MACE) after PCI.

Main Methods:

  • A cohort of 500 patients undergoing PCI was analyzed.
  • Patients were stratified based on the presence or absence of DM and HPR.
  • The primary endpoint was the occurrence of MACE at 5-year follow-up.

Main Results:

  • Patients with both DM and HPR exhibited the highest rates of MACE (37.9%), all-cause death (15.5%), and non-fatal myocardial infarction (25.9%).
  • The coexistence of DM and HPR independently predicted MACE (Hazard Ratio 3.46, p < 0.001).
  • This high-risk group received standard antiplatelet therapy with aspirin and clopidogrel.

Conclusions:

  • The combination of DM and HPR identifies a high-risk cohort among patients with stable CAD undergoing elective PCI.
  • These findings underscore the importance of assessing both DM and HPR for risk stratification and tailored management post-PCI.
  • Further research may explore intensified antiplatelet strategies or alternative therapies for this high-risk population.

Keywords:
Coronary artery diseaseDiabetes mellitusPercutaneous coronary interventionPlatelet function

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