Diabetic Status and Thrombogenicity: Association and Prognostic Implications After Percutaneous Coronary Intervention

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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

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Sungsoo Cho1, Moonki Jung2, Jong-Hwa Ahn3

  • 1Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.

JACC. Cardiovascular Interventions
|March 26, 2025
PubMed

Insights

Patients with diabetes mellitus (DM) have higher clot strength, increasing their risk for major adverse cardiovascular events (MACE). This heightened thrombogenicity, a key factor in DM patients, independently predicts MACE after percutaneous coronary intervention.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Thrombosis Research

Background:

  • Diabetes mellitus (DM) is associated with increased cardiovascular risk due to a prothrombotic state and accelerated atherosclerosis.
  • Understanding the interplay between DM, thrombogenicity, and cardiovascular outcomes is crucial for risk stratification and management.

Purpose of the Study:

  • To investigate the association between diabetes mellitus status and blood clot strength (thrombogenicity).
  • To evaluate the prognostic significance of thrombogenicity in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • Analysis of 2,501 patients with coronary artery disease undergoing PCI.
  • Measurement of on-admission glycated hemoglobin and thrombogenicity indexes using thromboelastography.
  • Assessment of major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction, or stroke over a 4-year follow-up.

Main Results:

  • Patients with DM exhibited significantly higher platelet-fibrin clot strength (PFCS) and reduced fibrinolytic activity compared to non-DM patients.
  • High PFCS (maximal amplitude ≥68 mm) and DM status were independently associated with an increased risk of MACE.
  • The combination of diabetic phenotype and high PFCS demonstrated an additive effect on MACE occurrence.

Conclusions:

  • Diabetic status is significantly correlated with increased clot strength in patients undergoing PCI.
  • A high clot-strength phenotype independently elevates the risk of MACE, regardless of diabetes status.
  • Thrombogenicity assessment may enhance risk prediction in patients with coronary artery disease, particularly those with diabetes.
Abstract

Keywords:
cardiovascular eventclot strengthcoronary artery diseasediabetes mellituspercutaneous coronary intervention

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