title: Chronic expression of platelet adhesion proteins is associated with severe ischemic heart disease in type 2 diabetic patients: Chronic platelet activation in diabetic heart patients.
abstract: Cardiac ischemia is a serious complication of type 2 diabetes. However, the pathophysiology underlying the increased severity of myocardial ischemia in diabetes is not clear. This study tested the hypothesis that platelet adhesion protein expression is chronically increased in older type 2 diabetic patients with established ischemic heart disease (IHD) compared to age-matched, nondiabetic patients with IHD. We compared the chronic expression of two platelet adhesion proteins, P-selectin and GPIIb/IIIa, in whole blood and the platelet reactivity to an acute stimulus. We found that the expression of platelet P-selectin was chronically increased in the nondiabetic patients with IHD compared to normal subjects. P-selectin expression was further increased in the diabetic patients with IHD compared to the nondiabetic IHD patients (P<.05). The results were stratified to examine the potential effect of aspirin usage on adhesion protein expression. We found that the expression of the activated GPIIb/IIIa complex was significantly reduced in those diabetic cardiac patients who were taking aspirin (P<.05). These findings indicate that, in patients with IHD, platelet adhesion proteins are chronically expressed and that the level of expression is increased more in IHD patients with type 2 diabetes. This complication of diabetes may exacerbate thrombus formation during a recurrent event, increasing the severity of ischemic injury. The results give further support to the use of aspirin in type 2 diabetics with established cardiac disease.
authors.affiliation: Cardiovascular and Thoracic Surgery and the Sarver Heart Center, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA. pmcdonag@u.arizona.edu
authors.forename: Paul F
authors.initials: PF
authors.lastname: McDonagh
authors.forename: Jason Y
authors.initials: JY
authors.lastname: Hokama
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Gale
authors.forename: Jeremy J
authors.initials: JJ
authors.lastname: Logan
authors.forename: Grace
authors.initials: G
authors.lastname: Davis-Gorman
authors.forename: Steve
authors.initials: S
authors.lastname: Goldman
authors.forename: Jack G
authors.initials: JG
authors.lastname: Copeland
mesh_terms: D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood*; D019007:P-Selectin / Q000097:blood* / Q000187:drug effects; D010972:Platelet Activating Factor / Q000494:pharmacology; D015539:Platelet Activation / Q000187:drug effects / Q000502:physiology*; D010973:Platelet Adhesiveness / Q000187:drug effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000032:analysis*; D012016:Reference Values
chemical_list: D015415:Biomarkers; D019007:P-Selectin; D010972:Platelet Activating Factor; D019039:Platelet Glycoprotein GPIIb-IIIa Complex