Diabetes & Metabolism Journal

Review

Current Antiplatelet Treatment Strategy in Patients with Diabetes Mellitus: Jung Hwa Jung, Udaya S. Tantry, Paul A. Gurbel, Young-Hoon Jeong; Diabetes Metab J. 2015;39(2):95-113. Published online April 20, 2015; DOI: https://doi.org/10.4093/dmj.2015.39.2.95

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Patients with diabetes mellitus (DM) have accelerated atherosclerosis with an increased risk for atherothrombotic cardiovascular complications. A state of high platelet reactivity and activation, hypercoagulability (prothrombotic state) and a subdued response to standard antiplatelet agents may explain high rate of adverse cardiovascular events in patients with DM. Several antithrombotic treatment strategies have been developed to control the prothrombotic state in patients with DM: dose modification of commonly used agents; use of potent agents; and addition of a third antithrombotic drug (triple therapy) to commonly prescribed dual antiplatelet therapy of aspirin and a P2Y₁₂ inhibitor. The present review aims to provide an overview of the current knowledge on platelet abnormalities in patients with DM, focusing on the challenges and perspectives of antiplatelet treatment strategies in this population.

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Original Articles

Prevalence and Clinical Characteristics of Aspirin Resistance in the Patients with Type 2 Diabetes Mellitus.: Mi Yeon Kang, Young Min Cho, Hyun Kyung Kim, Jee Hyun An, Hwa Young Ahn, Ji Won Yoon, Hoon Sung Choi, Jie Seon Lee, Kyong Soo Park, Seong Yeon Kim, Hong Kyu Lee; Korean Diabetes J. 2008;32(1):53-59. Published online February 1, 2008; DOI: https://doi.org/10.4093/kdj.2008.32.1.53

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BACKGROUND
We examined the prevalence and clinical characteristics of aspirin resistance in the Korean patients with type 2 diabetes mellitus. METHODS: We studied 181 Korean patients with type 2 diabetes mellitus who were taking aspirin (100 mg/day for > or = 3 months) and no other antiplatelet agents. The VerifyNow System was used to determine aspirin responsiveness. Aspirin resistance was defined as an aspirin reaction unit (ARU) > or = 550. We measured the cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) to evaluate arteriosclerosis. The anthropometric parameters, electrocardiogram, blood pressure, fasting plasma glucose, lipid profiles, hemoglobin A1c, highly sensitive C-reactive protein (hsCRP), homocysteine, and microalbuminuria were measured in each patient. RESULTS: The prevalence of aspirin resistance in type 2 diabetic patients was 9.4% (17 of 181). Those who had aspirin resistance were older than those without aspirin resistance (64.6 +/- 10.6 vs. 59.8 +/- 8.1, P = 0.024). Aspirin resistance was not associated with fasting plasma glucose, total cholesterol, triglyceride, LDL-cholesterol, HDL-cholesterol, hemoglobin A1c, hsCRP, homocysteine, microalbuminuria, ABI, CAVI, and body mass index. CONCLUSION: Prevalence of aspirin resistance in the Korean patients with type 2 diabetes mellitus was 9.4%. Although aspirin resistance was associated with old age, we could not find any good clinical parameter to predict it. Therefore, aspirin resistance should be evaluated in diabetic patients taking aspirin for prevention of cardiovascular complications.

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Long Non-Coding RNA H19 Positively Associates With Aspirin Resistance in the Patients of Cerebral Ischemic Stroke
Jue Wang, Bin Cao, Yan Gao, Dong Han, Haiping Zhao, Yuhua Chen, Yumin Luo, Juan Feng, Yanxia Guo
Frontiers in Pharmacology.2020;[Epub] CrossRef
6^th Asian PAD Workshop

Annals of Vascular Diseases.2015; 8(2): 135. CrossRef
Non-HDL cholesterol is an independent risk factor for aspirin resistance in obese patients with type 2 diabetes
Jong Dai Kim, Cheol-Young Park, Kue Jeong Ahn, Jae Hyoung Cho, Kyung Mook Choi, Jun Goo Kang, Jae Hyeon Kim, Ki Young Lee, Byung Wan Lee, Ji Oh Mok, Min Kyong Moon, Joong Yeol Park, Sung Woo Park
Atherosclerosis.2014; 234(1): 146. CrossRef

Current Status of Aspirin User in Korean Diabetic Patients Using Korean Health Insurance Database.: Ie Byung Park, Dae Jung Kim, Jaiyong Kim, Hyeyoung Kim, Hwayoung Kim, Kyung Wan Min, Seok Won Park, Jeong Hyun Park, Sei Hyun Baik, Hyun Shik Son, Chul Woo Ahn, Jee Young Oh, Sunhee Lee, Juneyoung Lee, Choon Hee Chung, Injeoung Choi, Kyung Mook Choi; Korean Diabetes J. 2006;30(5):363-371. Published online September 1, 2006; DOI: https://doi.org/10.4093/jkda.2006.30.5.363

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Abstract PDF

AIMS: ADA guidelines recommend aspirin for all patients with diabetes who have had a prior CHD events as well as a primary prevention strategy among those with at least one other risk factor. We examined the current status of regular aspirin intake among Korean adults who diagnosed as diabetes. METHODS: This study examined the characteristics of aspirin user in new-onset diabetes over 40 years based on health insurance claims submitted to the Health Insurance Review Agency (HIRA) of Korea during the period from January 2001 through December 2003. New onset diabetes defined as the first health insurance claim of antidiabetic drugs submitted to HIRA for the three months (January to March 2001) that never submitted for previous 6 years. RESULTS: The number of total new-onset diabetic patients was 30,014 in 2001, 29,819 in 2002, and 32,061 in 2003. The incidence rate of diabetes over 40 years for 3 months in 2001, 2002 and 2003 were 0.172%, 0.167% and 0.18. Mean age of women who diagnosed diabetes were significant higher than that of men in 2001 (women 59.2+/-10.6 yrs, men 54.8+/-9.8 yrs), in 2002 (women 59.5+/-10.6 yrs, men 54.6+/-9.3 yrs) and in 2003 (women 59.6+/-10.7 yrs, men 54.7+/-9.9 yrs) (p < 0.001). The number of aspirin user increased from 2,065 (6.9%) in 2001, 2,638 (8.9%) in 2002 and 3,711 (11.6%) in 2003. 30.5% of new-onset diabetics in 2001 had hypertension, 12.4% of them had hypercholesterolemia, 11.8% of them had cerebral infarct, 2.6% of them had cerebral hemorrhage, 3.8% of them had coronary heart disease and, but, 55.6% of them had not any CVD. Logistic regression analysis using aspirin use as a dependent variable showed that the number of aspirin use in patients with hypertension, hypercholesterolemia, cerebral infarct and coronary heart disease was higher than in patients without those (hypertension [OR], 3.89 (95% CI, 3.52~4.31); hypercholesterolemia [OR], 2.16 (95% CI, 1.90~2.46; cerebral infarct [OR], 2.05 (95% CI, 1.82~2.30); coronary heart disease [OR], 9.41 (95% CI, 8.20~10.80), respectively). Coronary heart disease was the most important associated factor of aspirin use. CONCLUSIONS: We found significant underuse of aspirin therapy among our population compared with that of America. Major efforts are needed to increase aspirin use in diabetic patients.

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Evaluation of low-dose aspirin for primary prevention of ischemic stroke among patients with diabetes: a retrospective cohort study
Ye-Jee Kim, Nam-Kyong Choi, Mi-Sook Kim, Joongyub Lee, Yoosoo Chang, Jong-Mi Seong, Sun-Young Jung, Ju-Young Shin, Ji-Eun Park, Byung-Joo Park
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Cause-of-Death Trends for Diabetes Mellitus over 10 Years
Su Kyung Park, Mi-Kyoung Park, Ji Hye Suk, Mi Kyung Kim, Yong Ki Kim, In Ju Kim, Yang Ho Kang, Kwang Jae Lee, Hyun Seung Lee, Chang Won Lee, Bo Hyun Kim, Kyung Il Lee, Mi Kyoung Kim, Duk Kyu Kim
Korean Diabetes Journal.2009; 33(1): 65. CrossRef
The Current Status of Type 2 Diabetes Management at a University Hospital
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Korean Diabetes Journal.2009; 33(3): 241. CrossRef

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