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Diabetes 54:2430-2435, 2005
© 2005 by the American Diabetes Association, Inc.

Platelet Function Profiles in Patients With Type 2 Diabetes and Coronary Artery Disease on Combined Aspirin and Clopidogrel Treatment

Dominick J. Angiolillo1, Antonio Fernandez-Ortiz2, Esther Bernardo2, Celia Ramírez2, Manel Sabaté2, Pilar Jimenez-Quevedo2, Rosana Hernández2, Raul Moreno2, Javier Escaned2, Fernando Alfonso2, Camino Bañuelos2, Marco A. Costa1, Theodore A. Bass1, and Carlos Macaya2

1 Division of Cardiology, University of Florida, Shands Jacksonville, Jacksonville, Florida
2 Cardiovascular Institute, San Carlos University Hospital, Madrid, Spain

To assess platelet function profiles in diabetic and nondiabetic patients on aspirin and clopidogrel therapy, two patient populations were included to investigate the 1) acute effects of a 300-mg clopidogrel loading dose (group 1, n = 52) and 2) long-term effects of clopidogrel (group 2, n = 120) on platelet function in diabetic compared with nondiabetic patients already on aspirin treatment. Patients were stratified according to the presence of type 2 diabetes. Platelet aggregation was assessed using light transmittance aggregometry (groups 1 and 2). Platelet activation (P-selectin expression and PAC-1 binding) was determined using whole-blood flow cytometry (group 2). Clopidogrel response was also assessed. In group 1, platelet aggregation was significantly increased in diabetic (n = 16) compared with nondiabetic (n = 36) patients at baseline and up to 24 h following a 300-mg loading dose (P = 0.005). In group 2, platelet aggregation and activation were increased in diabetic (n = 60) compared with nondiabetic (n = 60) subjects (P < 0.05 for all platelet function assays). Diabetic subjects had a higher number of clopidogrel nonresponders (P = 0.04). Diabetic patients have increased platelet reactivity compared with nondiabetic subjects on combined aspirin and clopidogrel treatment. Reduced sensitivity to antiplatelet drugs may contribute to the increased atherothombotic risk in diabetic patients.

Address correspondence and reprint requests to Dominick J. Angiolillo, MD, FACC, FESC, Division of Cardiology, University of Florida, Shands Jacksonville, 655 West 8th St., Jacksonville, FL 32209. E-mail: dominick.angiolillo{at}jax.ufl.edu

Abbreviations: CAD, coronary artery disease; GP, glycoprotein; PRP, platelet-rich plasma


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