Platelet hyperactivity in type 2 diabetes: role of antiplatelet agents.
Type 2 diabetes mellitus increases atherothrombotic risk. Platelets in individuals with diabetes show increased activity at baseline and in response to agonists, ultimately leading to increased aggregation. Increased expression of platelet surface adhesion molecules and receptors, enhanced production of thromboxane and thrombin and disturbances in platelet calcium homeostasis are well documented. As intra-arterial thrombi are initiated by platelets, strategies to limit acute thrombotic events have largely focused on antiplatelet agents. Aspirin remains the cornerstone of antiplatelet therapy but appears to have limited benefit in diabetes. Use of thienopyridines and platelet glycoprotein IIb/IIIa receptor inhibitors has been shown to benefit high-risk patient populations. This review summarises the different platelet abnormalities characterised in diabetes and the role of currently used antiplatelet agents.
Natarajan
Arun
A
Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital NHS Foundation Trust, Nethermayne, Basildon, Essex, SS16 5NL, UK.
Zaman
Azfar G
AG
Marshall
Sally M
SM
D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000517:prevention & control*
D010975:Platelet Aggregation Inhibitors