Platelet aggregation is not altered among men with diabetes mellitus
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Platelets are pivotal in arterial thrombosis, and platelet hyperresponsiveness may contribute to the increased incidence of cardiovascular events in diabetes mellitus. Consequently, we hypothesized that increased in vitro platelet aggregation responses exist in men with diabetes mellitus.
The Danish Cardiovascular Screening Trial (DANCAVAS) is a community-based cardiovascular screening trial including men aged 65–74 years. Platelet aggregation was tested using 96-well light transmission aggregometry with thrombin receptor-activating peptide (TRAP), adenosine diphosphate, collagen type 1, arachidonic acid and protease-activated receptor-4 in three concentrations. Further, cardiovascular risk factors and coronary artery calcification (CAC), estimated by CT scans and ankle–brachial index, were obtained.
Included were 720 men aged 65–74 years, 110 with diabetes mellitus. Overall, there was no difference in platelet aggregation among men with versus without diabetes mellitus when adjusting for or excluding platelet inhibitor treatment and men with established cardiovascular disease (CVD). This was true for all agonists, e.g., 10 µM TRAP-induced platelet aggregation of median 69% (IQR 53–75) versus 70% (IQR 60–76) in men with versus without diabetes mellitus. Platelet aggregation did not correlate with HbA1c or CAC. Men with diabetes mellitus displayed higher CAC, median 257 Agatston units (IQR 74–1141) versus median 111 Agatston units (IQR 6–420) in the remaining individuals, p < 0.0001.
Among outpatients with diabetes mellitus, but no CVD and no platelet inhibitor treatment, neither are platelets hyperresponsive in diabetes mellitus, nor is platelet aggregation associated with glycemic status or with the degree of coronary atherosclerosis.
KeywordsAtherosclerosis Platelet aggregation Diabetes mellitus Light transmission aggregometry Coronary artery calcification
Coronary artery calcification
Light transmission aggregometry
Thrombin receptor-activating peptide
The authors thank the entire staff of DANCAVAS.
CK contributed to study design, research, analysis and interpretation of the data, and writing of the manuscript. LMR contributed to study design, interpretation of the data and editing of the manuscript. JSL contributed to study design, interpretation of the data and editing of the manuscript. ACPD contributed to study design, interpretation of the data and editing of the manuscript. PJV contributed to study design, data analysis and interpretation of the data, and editing of the manuscript. CK is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
The study received research support from Odense University Hospital and from the Hansen-Bille Braheske Family foundation.
Compliance with ethical standards
Conflict of interest
The author declares that they have no conflict of interest.
Ethical standards disclosure
The study was approved by the Danish Data Protection Agency (16/18852) and the Regional Scientific Ethical Committees of Southern Denmark (S-20140028). The study was conducted in accordance with the guidelines of the Helsinki Declaration.
Informed consent disclosure
All persons gave written informed consent.
Availability of data and material
The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
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