Vivas Balcones, Luis DavidGarcía Rubira, Juan CarlosBernardo, EstherAngiolillo, Dominick J.Martín, PatriciaCalle Pascual, Alfonso LuisNúñez Gil, IvánMacaya Miguel, CarlosFernández Ortiz, Antonio Ignacio2024-02-072024-02-072013-02-01Vivas 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;35:165-7410.1007/s11239-012-0834-0929-5305https://hdl.handle.net/20.500.14352/99957Ensayo 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.engjournal articlehttps://link.springer.com/article/10.1007/s11239-012-0834-323114538https://pubmed.ncbi.nlm.nih.gov/23114538/restricted access616.12Ciencias Biomédicas32 Ciencias Médicas