The Impact of Type 2 Diabetes on the Efficacy of ADP Receptor Blockers in Patients with Acute ST Elevation Myocardial Infarction: A Pilot Prospective Study

Background. The aim of this study was to validate the impact of type 2 diabetes (T2D) on the platelet reactivity in patients with acute ST elevation myocardial infarction (STEMI) treated with adenosine diphosphate (ADP) receptor blockers.Methods. A pilot prospective study was performed. Totally 67 patients were enrolled. 21 patients had T2D. Among all study population, 33 patients received clopidogrel and 34 patients received prasugrel. The efficacy of ADP receptor blocker therapy had been tested in two time intervals using light transmission aggregometry with specific inducer and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) flow cytometry assay.Results. There were no significant differences in platelet aggregability among T2D and nondiabetic (ND) group. The platelet reactivity index of VASP-P did not differ significantly between T2D and ND group (59.4±30.9% versus60.0±25.2% and33.9±25.3% versus38.6±29.3% in second testing). The number of ADP receptor blocker nonresponders did not differ significantly between T2D and ND patients. The time interval from ADP receptor blocker loading dosing to the blood sampling was similar in T2D and ND patients in both examinations.Conclusion. This prospective study did not confirm the higher platelet reactivity and higher prevalence of ADP receptor blocker nonresponders in T2D acute STEMI patients.

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The Impact of Renal Dysfunction on Outcomes of In-Hospital and Remote Periods in Patients With ST-Elevation Myocardial Infarction Combined With Type 2 Diabetes Mellitus

Kardiologiia ◽

10.18565/cardio.2015.11.24-30 ◽

2015 ◽

Vol 11_2015 ◽

pp. 24-30 ◽

Cited By ~ 1

Author(s):

V.N. Karetnikova Karetnikova ◽

M.V. Evseeva Evseeva ◽

M.V. Zykov Zykov ◽

I.S. Bykova Bykova ◽

V.V. Kalaeva Kalaeva ◽

...

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Renal Dysfunction ◽

St Elevation Myocardial Infarction ◽

St Elevation ◽

The Impact

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Type 2 Diabetes and ADP Receptor Blocker Therapy

Journal of Diabetes Research ◽

10.1155/2016/6760710 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Matej Samoš ◽

Marián Fedor ◽

František Kovář ◽

Michal Mokáň ◽

Tomáš Bolek ◽

...

Keyword(s):

Type 2 Diabetes ◽

Clinical Practice ◽

Adverse Events ◽

Current Knowledge ◽

Platelet Reactivity ◽

Receptor Blocker ◽

Blocker Therapy ◽

Adp Receptor

Type 2 diabetes (T2D) is associated with several abnormalities in haemostasispredisposingto thrombosis. Moreover, T2D was recently connected with a failure in antiplatelet response to clopidogrel, the most commonly used ADP receptor blocker in clinical practice. Clopidogrel high on-treatment platelet reactivity (HTPR) was repeatedly associated with the risk of ischemic adverse events. Patients with T2D show significantly higher residual platelet reactivity on ADP receptor blocker therapy and are more frequently represented in the group of patients with HTPR. This paper reviews the current knowledge about possible interactions between T2D and ADP receptor blocker therapy.

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The impact of type 2 diabetes mellitus on prognosis in patients with non-ST elevation myocardial infarction

Polish Journal of Cardio-Thoracic Surgery ◽

10.5114/kitp.2017.68744 ◽

2017 ◽

Vol 2 ◽

pp. 127-132 ◽

Cited By ~ 1

Author(s):

Katarzyna Birkner ◽

Bartosz Hudzik ◽

Mariusz Gąsior

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

St Elevation Myocardial Infarction ◽

St Elevation ◽

The Impact

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Are there sex differences in the effect of type 2 diabetes in the incidence and outcomes of myocardial infarction? A matched-pair analysis using hospital discharge data

Cardiovascular Diabetology ◽

10.1186/s12933-021-01273-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Ana Lopez-de-Andres ◽

Rodrigo Jimenez-Garcia ◽

Valentin Hernández-Barrera ◽

Jose M. de Miguel-Yanes ◽

Romana Albaladejo-Vicente ◽

...

Keyword(s):

Myocardial Infarction ◽

Type 2 Diabetes ◽

Sex Differences ◽

Propensity Score ◽

Propensity Score Matching ◽

Hospital Discharge ◽

St Elevation Myocardial Infarction ◽

Men And Women ◽

St Elevation

Abstract Background To analyze incidence, use of therapeutic procedures, and in-hospital outcomes in patients with ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI) according to the presence of type 2 diabetes (T2DM) in Spain (2016–2018) and to investigate sex differences. Methods Using the Spanish National Hospital Discharge Database, we estimated the incidence of myocardial infarctions (MI) in men and women with and without T2DM aged ≥ 40 years. We analyzed comorbidity, procedures, and outcomes. We matched each man and woman with T2DM with a non-T2DM man and woman of identical age, MI code, and year of hospitalization. Propensity score matching was used to compare men and women with T2DM. Results MI was coded in 109,759 men and 44,589 women (30.47% with T2DM). The adjusted incidence of STEMI (IRR 2.32; 95% CI 2.28–2.36) and NSTEMI (IRR 2.91; 95% CI 2.88–2.94) was higher in T2DM than non-T2DM patients, with higher IRRs for NSTEMI in both sexes. The incidence of STEMI and NSTEMI was higher in men with T2DM than in women with T2DM. After matching, percutaneous coronary intervention (PCI) was less frequent among T2DM men than non-T2DM men who had STEMI and NSTEMI. Women with T2DM and STEMI less frequently had a code for PCI that matched that of non-T2DM women. In-hospital mortality (IHM) was higher among T2DM women with STEMI and NSTEMI than in matched non-T2DM women. In men, IHM was higher only for NSTEMI. Propensity score matching showed higher use of PCI and coronary artery bypass graft and lower IHM among men with T2DM than women with T2DM for both STEMI and NSTEMI. Conclusions T2DM is associated with a higher incidence of STEMI and NSTEMI in both sexes. Men with T2DM had higher incidence rates of STEMI and NSTEMI than women with T2DM. Having T2DM increased the risk of IHM after STEMI and NSTEMI among women and among men only for NSTEMI. PCI appears to be less frequently used in T2DM patients After STEMI and NSTEMI, women with T2DM less frequently undergo revascularization procedures and have a higher mortality risk than T2DM men.

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The Impact of Hypoglycemia on Productivity Loss and Utility in Type 2 Diabetes Patients Treated with Insulin in Real-World Canadian Practice: Protocol for a Prospective Study (Preprint)

10.2196/preprints.35461 ◽

2021 ◽

Author(s):

Veronique Lambert-Obry ◽

Jean-Philippe Lafrance ◽

Michelle Savoie ◽

Jean Lachaine

Keyword(s):

Type 2 Diabetes ◽

Prospective Study ◽

Real World ◽

Productivity Loss ◽

Economic Modeling ◽

Economic Evaluations ◽

Productivity Cost ◽

Productivity Losses ◽

The Impact

BACKGROUND Type 2 diabetes mellitus (T2DM) imposes a significant burden, with its increasing prevalence and life-threatening complications. In patients not achieving glycemic targets on oral antidiabetic drugs, initiation of insulin is recommended. However, a serious concern about insulin is drug-induced hypoglycemia. Hypoglycemia is known to affect quality of life and healthcare resource utilization. However, health economics and outcomes research (HEOR) data for economic modeling are limited, particularly in terms of utility values and productivity losses. OBJECTIVE The aim of this real-world prospective study is to assess the impact of hypoglycemia on productivity and utility in insulin-treated T2DM adults from Ontario and Quebec (Canada). METHODS This noninterventional, multicenter, 3-month prospective study will recruit patients from four medical clinics and two endocrinology/diabetes clinics. Patients will be identified using appointment lists, and enrolled through consecutive sampling during routinely scheduled consultations. To be eligible, patients must be ≥18 years of age, diagnosed with T2DM, and treated with insulin. Utility and productivity will be collected using the EQ-5D-5L questionnaire and the iMTA Productivity Cost Questionnaire (iPCQ), respectively. Questionnaires will be completed at 4, 8 and 12 weeks after recruitment. Generalized estimating equations (GEE) models will be used to investigate productivity losses and utility decrements associated with incident hypoglycemic events while controlling for individual patient characteristics. A total of 500 patients will be enrolled to ensure precision of HEOR estimates. RESULTS This study is designed to fill a gap in the Canadian evidence on the impact of hypoglycemia on HEOR outcomes. More specifically, it will generate productivity and utility inputs for economic modeling in T2DM. CONCLUSIONS Insulin therapies are expensive, and hypoglycemia is a significant component of economic evaluations. Robust HEOR data may help health technology assessment (HTA) agencies in future reimbursement decision making.

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Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in Slovenia

Balkan Journal of Medical Genetics ◽

10.2478/v10034-011-0011-6 ◽

2011 ◽

Vol 14 (1) ◽

pp. 3-9 ◽

Cited By ~ 9

Author(s):

S Kariž ◽

D Petrovič

Keyword(s):

Myocardial Infarction ◽

Type 2 Diabetes ◽

Gene Polymorphisms ◽

Serum Levels ◽

Control Group ◽

Interleukin 18 ◽

Significant Difference ◽

Promoter Gene ◽

The Impact

Interleukin-18 Promoter Gene Polymorphisms are not Associated with Myocardial Infarction in Type 2 Diabetes in SloveniaType 2 diabetes is a major risk factor for myocardial infarction (MI) and chronic inflammation may play a central role in both diseases. Interleukin (IL)-18 is a potent proinflammatory cytokine, which is considered important in acute coronary syndromes and type 2 diabetes. We investigated the association of the -137 (G>C), polymorphism (rs187238) and the -607 (C<A) polymorphism (rs1946518) of the IL-18 gene promoter region in 495 Caucasians with type 2 diabetes, of whom 169 had MI and 326 subjects had no clinically evident coronary artery disease (controls). We also investigated the impact of these polymorphisms on the serum IL-18 level in subsets of both groups and in a normal group. Genotype distributions of the polymorphisms showed no significant difference between cases and controls. However, IL-18 serum levels were significantly lower in diabetics with the137 CC genotype than in those with other genotypes (241.5 ± 132.7 ng/Lvs.340.2 ± 167.4 ng/L; p <0.05). High sensitivity C-reactive protein and IL-18 serum levels were higher in diabetics in the MI group than in the control group. We conclude that these IL-18 promoter gene polymorphisms are not risk factors for MI in Caucasians with type 2 diabetes.

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