Persistent platelet activation in patients with type 2 diabetes treated with low doses of aspirin.
BACKGROUND
The percentage of diabetic patients who do not benefit from the protective effect of aspirin is larger than in other populations at cardiovascular risk.


OBJECTIVE
We compared the ability of aspirin to suppress TxA2 and platelet activation in vivo, in type-2 diabetics vs. high-risk non-diabetic patients.


METHODS
Urinary 11-dehydro-TXB2, plasma sCD40 L, and sP-selectin were measured, together with indices of low-grade inflammation, glycemic control, and lipid profile, in 82 patients with type-2 diabetes and 39 without diabetes, treated with low doses of aspirin.


RESULTS
Urinary 11-dehydro-TxB2, plasma sCD40L and sP-selectin were significantly higher in diabetics than in controls: [38.9 (27.8-63.3) vs. 28.5 (22.5-43.9) ng mmol(-1) of creatinine, P = 0.02], [1.06 (0.42-3.06) vs. 0.35 (0.22-0.95) ng mL(-1); P = 0.0001], [37.0 (16.8-85.6) vs. 20.0 (11.2-35.6) ng mL(-1), P = 0.0001], respectively. The proportion of individuals with diabetes increased across quartiles of 11-dehydro-TxB2, sCD40L, and sP-selectin, with the highest quartiles of 11-dehydro-TxB2, sCD40L and sP-selectin, including 66%, 93.3%, and 93.3% of individuals with diabetes. Markers of platelet activation positively correlated with indices of glycemic control but not with markers of low-grade inflammation.


CONCLUSIONS
Platelet dysfunction associated with insufficient glycemic control, may mediate persistent platelet activation under aspirin treatment.
Evangelista
V
V
Department of Translational Pharmacology, Consorzio Mario Negri Sud, Santa Maria Imbaro, Chieti, Italy. evangelista@negrisud.it
de Berardis
G
G
Totani
L
L
Avanzini
F
F
Giorda
C B
CB
Brero
L
L
Levantesi
G
G
Marelli
G
G
Pupillo
M
M
Iacuitti
G
G
Pozzoli
G
G
di Summa
P
P
Nada
E
E
de Simone
G
G
Dell'Elba
G
G
Amore
C
C
Manarini
S
S
Pecce
R
R
Maione
A
A
Tognoni
G
G
Nicolucci
A
A
D001241:Aspirin / Q000494:pharmacology* / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000188:drug therapy; D038321:Glycemic Index; D006801:Humans; D007249:Inflammation; D015539:Platelet Activation / Q000187:drug effects; D013928:Thromboxane A2 / Q000037:antagonists & inhibitors
D015415:Biomarkers; D001786:Blood Glucose; D013928:Thromboxane A2; D001241:Aspirin