Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control
Open accessAbstract
Objectives This study was designed to determine whether blood thrombogenicity is related to chronic glycemic control in type 2 diabetes mellitus (T2DM).Background Type 2 diabetes mellitus is associated with accelerated atherosclerosis and a high rate of arterial thrombotic complications. Whether increased blood thrombogenicity is associated with glycemic control has not been properly tested.Methods Forty patients with T2DM with hemoglobin A1c (HbA1c) > or =7.5% were selected. Maintaining their current hypoglycemic therapies, patients were randomized into a conservative (diet modification plus placebo) or intensive (diet modification plus troglitazone) hypoglycemic regimen for three months. Blood thrombogenicity was measured at baseline and after three months with the Badimon ex vivo perfusion chamber and assessed as platelet-thrombus formation. The repeated measurements allowed every patient to be his/her own control.Results Patients in both groups (48% and 74% of the conservative and intensive groups, respectively) improved glucose control (HbA1c reduction > or =0.5%), showing a significant decrease in blood thrombogenicity. A significant positive correlation was observed between the reduction in thrombus formation and the reduction in HbA1c (r = 0.47, p < 0.01). The reduction in HbA1c achieved by both treatments was comparable. Patients without glycemic improvement showed no change in blood thrombogenicity. Improved glycemic control was the only significant predictor of a decrease in blood thrombogenicity.Conclusions In T2DM, there is an association between improved glycemic control and blood thrombogenicity reduction. The effect of glycemic control on the thrombotic complications of T2DM patients deserves further investigation.
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Higher glycoprotein IIb/IIIa receptor density and hyperglycemia-driven increases in adhesion molecules intensify thrombotic tendency and raise cardiovascular risk.
“Increased glycoprotein IIb/IIIa receptor density,36 along with hyperglycemia-mediated increases in adhesion molecules such as von Willebrand factor, vitronectin, and p-selectin,37,38 furthers this thrombotic propensity and elevates cardiovascular risk.26,39”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [39]
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- Authors
- Osende, J. I., Badimon, J. J., Fuster, V., Herson, P., Rabito, P., Vidhun, R., Zaman, A., Rodriguez, O. J., Lev, E. I., Rauch, U., Heflt, G., Fallon, J. T., & Crandall, J. P.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2001-11
- Volume
- 38
- Issue
- 5
- Pages
- 1307-1312
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2005998137
- Cited by
- 167
- References
- 30
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 1 · 2023: 7 · 2022: 6 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 2 · 2015: 9 · 2014: 7 · 2013: 8 · 2012: 7
- FWCI
- 5.83
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Newcastle University ePrints (Newcastle Univesity)
- Funders
- Pfizer
- Sociedad Española de Cardiología
- National Institutes of Health
- National Heart, Lung, and Blood Institute (P50HL54467-SCOR)
- National Center for Research Resources (5 M01-RR-0071, M01RR000071)
- Topics
- Health Sciences › Medicine › Hematology › Blood Coagulation and Thrombosis Mechanisms
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Blood properties and coagulation
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, glycemic control, HbA1c, platelet thrombus formation, troglitazone, dietary change, atherosclerosis
- MeSH terms
- Troglitazone, Analysis of Variance, Arteriosclerosis, Blood Coagulation, Blood Coagulation Tests, Chromans, Combined Modality Therapy, Diabetes Mellitus, Type 2, Diet, Diabetic, Double-Blind Method, Female, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Male, Middle Aged, Predictive Value of Tests, Thiazoles, Thrombosis, Thiazolidinediones
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