Impact of chronic kidney disease on platelet function profiles in diabetes mellitus patients with coronary artery disease taking dual antiplatelet therapy

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dc.contributor.authorAngiolillo, Dominick J.
dc.contributor.authorBernardo, Esther
dc.contributor.authorVivas Balcones, Luis David
dc.contributor.authorSabaté, Manel
dc.contributor.authorJimenez Quevedo, Pilar
dc.contributor.authorAlfonso Manterola, Fernando
dc.contributor.authorMacaya Miguel, Carlos
dc.contributor.authorFernández Ortiz, Antonio Ignacio
dc.date.accessioned2024-02-07T08:54:54Z
dc.date.available2024-02-07T08:54:54Z
dc.date.issued2010-03-16
dc.descriptionEstudio observacional donde se evaluó a 306 pacientes con diabetes mellitus y enfermedad arterial coronaria en tratamiento antiagregante con aspirina y clopidogrel, en función de si presentaban enfermedad renal. El estudio concluyó que aquellos pacientes con enfermedad renal presentaron una peor respuesta a la inhibición plaquetaria que aquellos que no presentaban enfermedad renal relevante.
dc.description.abstractObjectives: We sought to assess the impact of renal function on platelet reactivity in patients with diabetes mellitus (DM) and coronary artery disease on aspirin and clopidogrel therapy. Background: Diabetes mellitus is a key risk factor for chronic kidney disease (CKD). In aspirin-treated DM patients the presence of moderate/severe CKD is associated with reduced clinical efficacy of adjunctive clopidogrel therapy. Whether these findings may be attributed to differences in clopidogrel-induced effects is unknown. Methods: This was a cross-sectional observational study in which DM patients taking maintenance aspirin and clopidogrel therapy were studied. Patients were categorized into 2 groups according to the presence or absence of moderate/severe CKD. Platelet aggregation after adenosine diphosphate (ADP) and collagen stimuli were assessed with light transmittance aggregometry and defined patients with high post-treatment platelet reactivity (HPPR). Markers of platelet activation, including glycoprotein IIb/IIIa activation and P-selectin expression, were also determined using flow cytometry. Results: A total of 306 DM patients were analyzed. Patients with moderate/severe CKD (n = 84) had significantly higher ADP-induced (60 +/- 13% vs. 52 +/- 15%, p = 0.001) and collagen-induced (49 +/- 20% vs. 41 +/- 20%, p = 0.004) platelet aggregation compared with those without (n = 222). After adjustment for potential confounders, patients with moderate/severe CKD were more likely to have HPPR after ADP (adjusted odds ratio: 3.8, 95% confidence interval: 1.7 to 8.5, p = 0.001) and collagen (adjusted odds ratio: 2.4; 95% confidence interval: 1.1 to 5.4; p = 0.029) stimuli. Markers of platelet activation were significantly increased in patients with HPPR. Conclusions: In DM patients with coronary artery disease taking maintenance aspirin and clopidogrel therapy, impaired renal function is associated with reduced clopidogrel-induced antiplatelet effects and a greater prevalence of HPPR.
dc.description.departmentDepto. de Medicina
dc.description.facultyFac. de Medicina
dc.description.refereedTRUE
dc.description.statuspub
dc.identifier.citationAngiolillo DJ, Bernardo E, Capodanno D, Vivas D, Sabaté M, Ferreiro JL, et al. Impact of chronic kidney disease on platelet function profiles in diabetes mellitus patients with coronary artery disease taking dual antiplatelet therapy. J Am Coll Cardiol. 2010;55:1139-46
dc.identifier.doi10.1016/j.jacc.2009.10.043
dc.identifier.issn0735-1097
dc.identifier.officialurlhttps://www.sciencedirect.com/science/article/pii/S0735109710000847?via%3Dihub
dc.identifier.pmid20223369
dc.identifier.relatedurlhttps://pubmed.ncbi.nlm.nih.gov/20223369/
dc.identifier.urihttps://hdl.handle.net/20.500.14352/99768
dc.issue.number11
dc.journal.titleJournal of the American College of Cardiology
dc.language.isoeng
dc.page.final1146
dc.page.initial1139
dc.publisherElsevier
dc.rights.accessRightsrestricted access
dc.subject.cdu616.1/.9
dc.subject.keywordClopidogrel
dc.subject.keywordChronic kidney disease
dc.subject.keywordDiabetes mellitus
dc.subject.keywordPlatelets
dc.subject.ucmCiencias Biomédicas
dc.subject.unesco32 Ciencias Médicas
dc.titleImpact of chronic kidney disease on platelet function profiles in diabetes mellitus patients with coronary artery disease taking dual antiplatelet therapy
dc.typejournal article
dc.type.hasVersionVoR
dc.volume.number55
dspace.entity.typePublication
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