Cardiovasc Diabetol: If blood sugar is not well controlled, the antithrombotic effect of aspirin will be greatly reduced!

Whether it is type 1 (T1D) or type 2 (T2D) diabetes , the risk of atherosclerotic thrombotic events such as acute coronary syndrome , thrombotic stroke and severe limb ischemia will increase
.

In these cases, platelet activation and fibrin network formation arethe key to the formation of obstructive thrombosisin blood vessels

Whether it is type 1 (T1D) or type 2 (T2D) diabetes , the risk of atherosclerotic thrombotic events such as acute coronary syndrome , thrombotic stroke and severe limb ischemia will increase

Aspirin (acetylsalicylic acid) is an irreversible inhibitor of cyclooxygenase (COX) enzyme.

Although aspirin is a key antiplatelet drug, its therapeutic effects on diabetic patients are not consistent, and the optimal dosing regimen is still unclear

In this open crossover study, a total of 48 type 1 diabetic patients and 48 healthy controls were randomized to receive aspirin 75 or 300 mg once a day (OD)
.

Before and at the end of each treatment period, light transmittance aggregation determination and fibrin clot study were performed

Type 1 diabetes

The results show that compared with the control group, aspirin has a lower inhibitory effect on collagen-induced platelet aggregation (PA) in diabetic patients, and high-dose aspirin is more effective
.

In the control group, higher doses of aspirin promoted thrombolysis, but not in diabetic patients

Threshold analysis showed that HbA1c levels >65 mmol/mol and >70 mmol/mol were associated with adverse reactions of aspirin to 75 and 300 mg daily doses, respectively

Correlation between glycosylated hemoglobin level and antithrombotic effect

Correlation between glycosylated hemoglobin level and antithrombotic effect

In summary, compared with healthy controls, diabetic patients have an impaired response to aspirin, which is reflected in reduced platelet inhibition and lack of fibrinolytic activity
.

Increasing the dose of aspirin in diabetic patients has little effect on the blood clotting cells and protein arms, and the decreased response to the drug seems to be related to insufficient diabetes control

In summary, compared with healthy controls, diabetic patients have an impaired response to aspirin, which is reflected in reduced platelet inhibition and lack of fibrinolytic activity

References: Parker, WAE, Sagar, R.
, Kurdee, Z.
et al.
A randomised controlled trial to assess the antithrombotic effects of aspirin in type 1 diabetes: role of dosing and glycaemic control.
Cardiovasc Diabetol 20,238 (2021) .
https://doi.
org/10.
1186/s12933-021-01427-y  Parker, WAE, Sagar, R.
, Kurdee, Z.
  et al.
 A randomised controlled trial to assess the antithrombotic effects of aspirin in type 1 diabetes: role of dosing and glycaemic control.
  Cardiovasc Diabetol 20,  238 (2021).
https://doi.
org/10.
1186/s12933-021-01427-y https://doi.
org/10.
1186/s12933-021-01427-y Leave a message here