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State-of-the-Art: Hypo-responsiveness to Oral Antiplatelet Therapy in Patients with Type 2 Diabetes Mellitus

  • Secondary Prevention + Intervention (M O' Donoghue, Section Editor)
  • Published:
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Abstract

Diabetes mellitus is a global pandemic, associated with a high burden of cardiovascular disease. There are multiple platelet derangements in patients with diabetes, and antiplatelet drugs remain the first-line agents for secondary prevention as well as for high-risk primary prevention among patients with diabetes. This review provides a summary of oral antiplatelet drug hypo-responsiveness in patients with diabetes, specifically aspirin and clopidogrel resistance. Topics discussed include antiplatelet testing, definitions used to define hypo-response and resistance, its prevalence, association with clinical outcomes, and strategies to mitigate resistance. The role of prasugrel and ticagrelor, as well as investigational agents, is also discussed.

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Acknowledgements

Dr. Alvarez’s effort was supported by NIH grant K08DK101602.

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Conflict of Interest

Carlos Alvarez received grants from the NIH. Dharam Kumbhani has no disclosures. Steven Marso received grants and personal fees and non-financial support from Novo Nordisk. Marso received grants and personal fees from St. Jude Medical, Terumo and The Medicine Company. Marso also received grants from Astra Zeneca and Bristol Myers Squibb. Darren McGuire received research grant support and personal fees and non-financial support from Novo Nordisk, Astra Zeneca, Bristol Myers Squibb, GlaxoSmithKline, The Medicines Company, Takeda Pharmaceuticals, Janssen, Eli Lilly, Boehringer Ingelheim, Merck, Regeneron, Lexicon, and Sanofi Aventis.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9047, USA

    Dharam J. Kumbhani & Steven P. Marso

  2. Texas Tech University Health Sciences Center, 5920 Forest Park Road, Dallas, TX, 75235, USA

    Carlos A. Alvarez

  3. UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-8830, USA

    Darren K. McGuire

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  1. Dharam J. Kumbhani
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  2. Steven P. Marso
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  3. Carlos A. Alvarez
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  4. Darren K. McGuire
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Correspondence to Darren K. McGuire.

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This article is part of the Topical Collection on Secondary Prevention + Intervention

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Kumbhani, D.J., Marso, S.P., Alvarez, C.A. et al. State-of-the-Art: Hypo-responsiveness to Oral Antiplatelet Therapy in Patients with Type 2 Diabetes Mellitus. Curr Cardiovasc Risk Rep 9, 4 (2015). https://doi.org/10.1007/s12170-014-0430-5

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