2026-07-01T03:24:57Zhttps://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

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") Vivas Balcones, Luis David García Rubira, Juan Carlos Bernardo, Esther Angiolillo, Dominick J. Martín, Patricia Calle Pascual, Alfonso Luis Núñez Gil, Iván Macaya Miguel, Carlos Fernández Ortiz, Antonio Ignacio 616.12 Ciencias Biomédicas 32 Ciencias Médicas Ensayo clínico aleatorizado donde se evaluó si un control intensivo de la glucemia frente a uno convencional en pacientes con un síndrome coronario agudo se asociaba a una menor reactividad plaquetaria en función del control glucémico previo medido por la HbA1c. Los pacientes con peor control glucémico previo y tratamiento intensivo de su hiperglucemia presentaron menor reactividad plaquetaria, no así los que presentaban niveles de HbA1c < 6.5%. 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. Depto. de Medicina Fac. de Medicina TRUE pub 2024-02-07T12:28:41Z 2024-02-07T12:28:41Z 2013-02-01 journal article VoR https://hdl.handle.net/20.500.14352/99957 XXXX-XXXX 10.1007/s11239-012-0834- 0929-5305 eng 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 restricted access application/pdf Springer