Kumbhani Dharam J, Marso Steven P, Alvarez Carlos A, McGuire Darren K
UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9047, /
UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-, /
Curr Cardiovasc Risk Rep. 2015 Jan;9:4. doi: 10.1007/s12170-014-0430-5.
Diabetes mellitus is a global pandemic, associated with a high burden of cardiovascular disease. There are multiple platelet derangements in patients with diabetes, and antiplatelet drugs remain the first-line agents for secondary prevention as well as for high-risk primary prevention among patients with diabetes. This review provides a summary of oral antiplatelet drug hypo-responsiveness in patients with diabetes, specifically aspirin and Clopidogrel resistance. Topics discussed include antiplatelet testing, definitions used to define hypo-response and resistance, its prevalence, association with clinical outcomes and strategies to mitigate resistance. The role of prasugrel and ticagrelor, as well as investigational agents, is also discussed.
糖尿病是一种全球性的流行病,与心血管疾病的高负担相关。糖尿病患者存在多种血小板紊乱情况,抗血小板药物仍是糖尿病患者二级预防以及高危一级预防的一线用药。本综述总结了糖尿病患者口服抗血小板药物低反应性,特别是阿司匹林和氯吡格雷抵抗的情况。讨论的主题包括抗血小板检测、用于定义低反应性和抵抗的定义、其患病率、与临床结局的关联以及减轻抵抗的策略。还讨论了普拉格雷和替格瑞洛的作用以及研究性药物的作用。