2026-06-30T20:34:25Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/999572024-02-18T01:19:51Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Vivas Balcones, Luis David author García Rubira, Juan Carlos author Bernardo, Esther author Angiolillo, Dominick J. author Martín, Patricia author Calle Pascual, Alfonso Luis author Núñez Gil, Iván author Macaya Miguel, Carlos author Fernández Ortiz, Antonio Ignacio author 2013-02-01 Patients with hyperglycemia, an acute coronary syndrome and poor glycemic control have increased platelet reactivity and poor prognosis. However, it is unclear the influence of a tight glycemic control on platelet reactivity in these patients. This is a subanalysis of the CHIPS study. This trial randomized patients with hyperglycemia to undergo an intensive glucose control (target blood glucose 80-120 mg/dL), or conventional glucose control (target blood glucose <180 mg/dL). We analyzed platelet function at discharge on the subgroup of patients with poor glycemic control, defined with admission levels of HbA1c higher than 6.5%. The primary endpoint was maximal platelet aggregation following stimuli with 20 μM ADP. We also measured aggregation following collagen, epinephrine, and thrombin receptor-activated peptide, as well as P2Y12 reactivity index and surface expression of glycoprotein IIb/IIIa and P-selectin. A total of 67 patients presented HbA1c ≥ 6.5% (37 intensive, 30 conventional), while 42 had HbA1c < 6.5% (20 intensive, 22 conventional). There were no differences in baseline characteristics between groups. At discharge, patients with HbA1c ≥6.5% had significantly reduced MPA with intensive glucose control compared with conventional control (46.1 ± 22.3 vs. 60.4 ± 20.0%; p = 0.004). Similar findings were shown with other measures of platelet function. However, glucose control strategy did not affect platelet function parameters in patients with HbA1c < 6.5%. Intensive glucose control in patients presenting with an acute coronary syndrome and hyperglycemia results in a reduction of platelet reactivity only in the presence of elevated HbA1c levels. Vivas D, Garcia-Rubira JC, Bernardo E, Angiolillo DJ, Martín P, Calle-Pascual A, et al. Influence of HbA1c levels on platelet function profiles associated with tight glycemic control in patients presenting with hyperglycemia and an acute coronary syndrome. A subanalysis of the CHIPS Study ("Control de HIperglucemia y Actividad Plaquetaria en Pacientes con Síndrome Coronario Agudo"). J Thromb Thrombolysis. 2013;35:165-74 10.1007/s11239-012-0834- 0929-5305 https://hdl.handle.net/20.500.14352/99957 https://link.springer.com/article/10.1007/s11239-012-0834-3 23114538 https://pubmed.ncbi.nlm.nih.gov/23114538/ Influence of HbA1c levels on platelet function profiles associated with tight glycemic control in patients presenting with hyperglycemia and an acute coronary syndrome. A subanalysis of the CHIPS Study ("Control de HIperglucemia y Actividad Plaquetaria en Pacientes con Síndrome Coronario Agudo")