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Interaction Between Diabetes Mellitus and Platelet Reactivity in Determining Long-Term Outcomes Following Percutaneous Coronary Intervention

  • Fabio MangiacapraEmail author
  • Edoardo Bressi
  • Iginio Colaiori
  • Elisabetta Ricottini
  • Ilaria Cavallari
  • Marialessia Capuano
  • Michele Matia Viscusi
  • Silvia Spoto
  • Emanuele Barbato
  • Germano Di Sciascio
Original Article
  • 22 Downloads

Abstract

Diabetes mellitus (DM) is an independent predictor of adverse outcomes in patients with coronary artery disease (CAD). We investigated the interaction between DM and high platelet reactivity (HPR) in determining long-term clinical outcomes after percutaneous coronary intervention (PCI). We enrolled 500 patients who were divided based on the presence of DM and HPR. Primary endpoint was the occurrence of major adverse clinical events (MACE) at 5 years. Patients with both DM and HPR showed the highest estimates of MACE (37.9%, log-rank p < 0.001), all-cause death (15.5%, log-rank p = 0.022), and non-fatal myocardial infarction (25.9%, log-rank p < 0.001). At Cox proportional hazard analysis, the coexistence of DM and HPR was an independent predictor of MACE (HR 3.46, 95% CI 1.67–6.06, p < 0.001). Among patients with stable CAD undergoing elective PCI and treated with aspirin and clopidogrel, the combination of DM and HPR identifies a cohort of patients with the highest risk of MACE at 5 years.

Keywords

Coronary artery disease Diabetes mellitus Percutaneous coronary intervention Platelet function 

Abbreviations

CAD

coronary artery disease

DM

diabetes mellitus

HPR

high platelet reactivity

PCI

percutaneous coronary intervention

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Fabio Mangiacapra
    • 1
    Email author
  • Edoardo Bressi
    • 1
  • Iginio Colaiori
    • 1
  • Elisabetta Ricottini
    • 1
  • Ilaria Cavallari
    • 1
  • Marialessia Capuano
    • 1
  • Michele Matia Viscusi
    • 1
  • Silvia Spoto
    • 2
  • Emanuele Barbato
    • 3
  • Germano Di Sciascio
    • 1
  1. 1.Unit of Cardiovascular Science, Department of MedicineCampus Bio-Medico UniversityRomeItaly
  2. 2.Unit of Internal Medicine, Department of MedicineCampus Bio-Medico UniversityRomeItaly
  3. 3.Department of Advanced Biomedical SciencesUniversity of Naples Federico IINaplesItaly

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