Comparison of Triple Anti-Platelet Therapy (Aspirin, Clopidogrel, and Cilostazol) and Double Anti-Platelet Therapy (Aspirin and Clopidogrel) on Platelet Aggregation in Type 2 Diabetic Patients Undergoing Drug-Eluting Stent Implantation.
10.4070/kcj.2009.39.11.462
- Author:
Tae Hyun YANG
1
;
Doo Il KIM
;
Jong Yoon KIM
;
Il Hwan KIM
;
Ki Hun KIM
;
Yang Chun HAN
;
Woong KIM
;
Sang Hoon SEOL
;
Seong Man KIM
;
Dae Kyeong KIM
;
Dong Soo KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Cardiovascular Research Institute, Busan Paik Hospital, Busan, Korea. yangthmd@naver.com
- Publication Type:Original Article
- Keywords:
Antiplatelet drugs;
Diabetes mellitus;
Platelet aggregation;
Stents
- MeSH:
Adenosine Diphosphate;
Blood Platelets;
Diabetes Mellitus;
Drug-Eluting Stents;
Humans;
Light;
Platelet Aggregation;
Platelet Aggregation Inhibitors;
Stents;
Tetrazoles;
Thrombosis;
Ticlopidine
- From:Korean Circulation Journal
2009;39(11):462-466
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Triple anti-platelet therapy may produce more potent inhibition of platelet aggregation in patients undergoing coronary stent implantation. We tested whether this effect could be maintained in diabetic patients, where platelet reactivity is increased and the risk of stent thrombosis is higher. SUBJECTS AND METHODS: Fifty five type 2 diabetic patients who had undergone drug-eluting stent (DES) implantation and chronic anti-platelet therapy (>1 month) were stratified according to the status of anti-platelet therapy. Platelet aggregation after adenosine diphosphate (ADP; 10 micronmol/L and 20 micronmol/L) stimulation was compared using light transmittance aggregometry between dual (aspirin plus clopidogrel, n=34) and triple therapy (aspirin, clopidogrel plus cilostazol, n=21) groups. RESULTS: The 2 groups had similar clinical and procedural characteristics. Maximal ADP-induced platelet aggregation was significantly lower in the triple therapy group than the dual therapy group (ADP 10 micronmol/L, 37.1+/-15.4 vs. 28.3+/-11.8, p=0.03; ADP 20 micronmol/L, 63.1+/-15.0 vs. 49.1+/-15.1, p=0.01), but there were no differences in diabetic treatment (oral hypoglycemic agent vs. insulin) or diabetic control {hemoglobin Alc (HbA1c)< or =7 vs. HbA1c >7}. CONCLUSION: Triple anti-platelet therapy showed more potent inhibition of maximal ADP induced platelet aggregation in type 2 diabetic patients receiving chronic anti-platelet therapy. This finding suggests that triple antiplatelet therapy may be more effective in preventing thrombotic complications after DES implantation in type 2 diabetic patients.
