Increased atherothrombotic burden in patients with diabetes mellitus and acute coronary syndrome: a review of antiplatelet therapy.

Cardiology Research and Practice
Karthik BalasubramaniamAzfar G Zaman

Abstract

Patients with diabetes mellitus presenting with acute coronary syndrome have a higher risk of cardiovascular complications and recurrent ischemic events when compared to nondiabetic counterparts. Different mechanisms including endothelial dysfunction, platelet hyperactivity, and abnormalities in coagulation and fibrinolysis have been implicated for this increased atherothrombotic risk. Platelets play an important role in atherogenesis and its thrombotic complications in diabetic patients with acute coronary syndrome. Hence, potent platelet inhibition is of paramount importance in order to optimise outcomes of diabetic patients with acute coronary syndrome. The aim of this paper is to provide an overview of the increased thrombotic burden in diabetes and acute coronary syndrome, the underlying pathophysiology focussing on endothelial and platelet abnormalities, currently available antiplatelet therapies, their benefits and limitations in diabetic patients, and to describe potential future therapeutic strategies to overcome these limitations.

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Citations

Aug 9, 2012·Current Diabetes Reports·Giselle GuerraGaetano Ciancio
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Methods Mentioned

BETA
coronary artery bypass
PMA
flow cytometry
rheology

Clinical Trials Mentioned

ISRCTN48110081
NCT00135226

Software Mentioned

OPTIMUS

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