Higher Dose Clopidogrel Improves Platelet Inhibition In Diabetics

High clopidogrel maintenance dosing improves platelet inhibition in some diabetics who do not respond adequately to standard doses, according to a new report. Dr. Angiolillo and colleagues investigated whether increasing the dose of clopidogrel to 150 mg/day would enhance platelet inhibition in patients with type 2 diabetes who had less than 50% platelet inhibition on a standard 75 mg/day regimen.
After 1 month of treatment at the higher dose, patients showed a mean increase in platelet inhibition from 27.1% to 40.6%, the authors report.

Similarly, platelet aggregation decreased and platelet disaggregation increased after treatment with clopidogrel 150 mg.
Despite these improvements, platelet inhibition and antiplatelet effects remained significantly lower than those observed in patients with platelet inhibition of at least 50% while receiving treatment with clopidogrel 75 mg.

"We are currently evaluating other antiplatelet agents in patients with diabetes," Dr. Angiolillo explained. "The rationale for performing these studies is to evaluate how we can optimize platelet inhibition in patients with diabetes. In fact, diabetic patients are characterized by enhanced platelet reactivity and reduced sensitivity to aspirin and clopidogrel. This may explain why these patients continue to have an increased atherothrombotic risk even when on dual antiplatelet therapy."

"It is critical to follow-up with these patients and guarantee that they are compliant to their medication, in particular their ‘blood thinners,’" Dr. Angiolillo said. "Although there is growing evidence on the prognostic implications of inadequate platelet inhibition, platelet function testing should not be performed routinely in clinical practice but used only as a research tool at the current stage."
Am J Cardiol 2008;101:440-445. 

================================

DID YOU KNOW:
DIABETES TOLL CONTINUES TO GROW: Federal projections estimate that by 2050, some 48 million Americans will have type 2 diabetes. And the disease will bring with it complications such as blindness, hearing loss, kidney disease, nervous system disorders and amputations of extremities.  Studies have suggested that for the first time in history, the generation of people born in 2000 is probably going to have shorter life expectancy than their parents.  Still, medical experts say the fight against diabetes can be won — if everyone decides to do what’s best for themselves and their families.  That fight will get its yearly boost on Tuesday when the American Diabetes Association will "sound the alert" about diabetes on the 20th annual American Diabetes Alert Day. It’s a one-day "call to action" to encourage those at risk for developing type 2 diabetes or those with loved ones at risk to take the Diabetes Risk Test   The Diabetes Risk Test is available in English and Spanish by calling the association at 1-800-DIABETES (1-800-342-2383) or online at www.diabetes.org/alert.

================================

Help us keep this newsletter free-update your profile.

https://www.diabetesincontrol.com/surveys/index.php