Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy

Objectives: Diabetes mellitus (DM) is a significant risk factor for ischemic stroke and associated with platelet reactivity. We aim to evaluate the effect of DM on platelet function in acute ischemic stroke patients taking dual antiplatelet therapy (DAPT).Methods: We consecutively included patients...

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Autores principales:	Yinping Guo, Yi Zhang, Jing Zhao, Lingshan Wu, Zhiyuan Yu, Dan He, Hao Huang, Xiang Luo
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	diabetes mellitus dual antiplatelet therapy (DAPT) ischemic stroke platelet function thromboelastography (TEG) Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/4825ac58525a41bf8e4a251a7c7922b1
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spelling	oai:doaj.org-article:4825ac58525a41bf8e4a251a7c7922b12021-11-04T04:41:27ZImpact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy1664-229510.3389/fneur.2021.712024https://doaj.org/article/4825ac58525a41bf8e4a251a7c7922b12021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fneur.2021.712024/fullhttps://doaj.org/toc/1664-2295Objectives: Diabetes mellitus (DM) is a significant risk factor for ischemic stroke and associated with platelet reactivity. We aim to evaluate the effect of DM on platelet function in acute ischemic stroke patients taking dual antiplatelet therapy (DAPT).Methods: We consecutively included patients with acute ischemic stroke taking DAPT. Platelet function was assessed by thromboelastography and the arachidonic acid (AA) or adenosine diphosphate (ADP) induced platelet inhibition rate were used to confirmed the high-residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel. We classified patients into DM and non-DM groups. The association between DM and platelet function was assessed and the confounding factors were adjusted by propensity score matching (PSM) analysis. The independent risk factors of HRPR were determined by multivariate logistic regression analysis.Results: A total of 1,071 acute ischemic stroke patients, 712 in the non-DM group and 359 in the DM group, were included. Patients with DM had a significantly higher maximum amplitude (63.0 vs. 62.0 mm, P < 0.01), ADP-induced clot strength (34.6 vs. 30.3 mm, P < 0.01) and clopidogrel HRPR rate (22.6% vs. 17.3%, P = 0.038) than those without DM. Among 662 patients after PSM, the maximum amplitude (63.1 vs. 62.5 mm, P = 0.032), ADP-induced clot strength (34.6 vs. 29.3 mm, P < 0.01) and clopidogrel HRPR rate (23.0% vs. 15.7%, P = 0.018) is still higher in the DM group. DM was an independent factor of clopidogrel HRPR (OR = 1.48, 95% CI: 1.03–2.07, P < 0.05).Conclusions: In acute ischemic stroke patients taking DAPT, DM is associated with increased platelet reactivity and higher prevalence of clopidogrel HRPR.Yinping GuoYi ZhangJing ZhaoLingshan WuZhiyuan YuDan HeDan HeHao HuangXiang LuoFrontiers Media S.A.articlediabetes mellitusdual antiplatelet therapy (DAPT)ischemic strokeplatelet functionthromboelastography (TEG)Neurology. Diseases of the nervous systemRC346-429ENFrontiers in Neurology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diabetes mellitus dual antiplatelet therapy (DAPT) ischemic stroke platelet function thromboelastography (TEG) Neurology. Diseases of the nervous system RC346-429
spellingShingle	diabetes mellitus dual antiplatelet therapy (DAPT) ischemic stroke platelet function thromboelastography (TEG) Neurology. Diseases of the nervous system RC346-429 Yinping Guo Yi Zhang Jing Zhao Lingshan Wu Zhiyuan Yu Dan He Dan He Hao Huang Xiang Luo Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
description	Objectives: Diabetes mellitus (DM) is a significant risk factor for ischemic stroke and associated with platelet reactivity. We aim to evaluate the effect of DM on platelet function in acute ischemic stroke patients taking dual antiplatelet therapy (DAPT).Methods: We consecutively included patients with acute ischemic stroke taking DAPT. Platelet function was assessed by thromboelastography and the arachidonic acid (AA) or adenosine diphosphate (ADP) induced platelet inhibition rate were used to confirmed the high-residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel. We classified patients into DM and non-DM groups. The association between DM and platelet function was assessed and the confounding factors were adjusted by propensity score matching (PSM) analysis. The independent risk factors of HRPR were determined by multivariate logistic regression analysis.Results: A total of 1,071 acute ischemic stroke patients, 712 in the non-DM group and 359 in the DM group, were included. Patients with DM had a significantly higher maximum amplitude (63.0 vs. 62.0 mm, P < 0.01), ADP-induced clot strength (34.6 vs. 30.3 mm, P < 0.01) and clopidogrel HRPR rate (22.6% vs. 17.3%, P = 0.038) than those without DM. Among 662 patients after PSM, the maximum amplitude (63.1 vs. 62.5 mm, P = 0.032), ADP-induced clot strength (34.6 vs. 29.3 mm, P < 0.01) and clopidogrel HRPR rate (23.0% vs. 15.7%, P = 0.018) is still higher in the DM group. DM was an independent factor of clopidogrel HRPR (OR = 1.48, 95% CI: 1.03–2.07, P < 0.05).Conclusions: In acute ischemic stroke patients taking DAPT, DM is associated with increased platelet reactivity and higher prevalence of clopidogrel HRPR.
format	article
author	Yinping Guo Yi Zhang Jing Zhao Lingshan Wu Zhiyuan Yu Dan He Dan He Hao Huang Xiang Luo
author_facet	Yinping Guo Yi Zhang Jing Zhao Lingshan Wu Zhiyuan Yu Dan He Dan He Hao Huang Xiang Luo
author_sort	Yinping Guo
title	Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
title_short	Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
title_full	Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
title_fullStr	Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
title_full_unstemmed	Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
title_sort	impact of diabetes on platelet function in acute ischemic stroke patients taking dual antiplatelet therapy
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/4825ac58525a41bf8e4a251a7c7922b1
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Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy

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