antiplatelet in diabetes - Cardiovascular disease CVD is a significant berjalan untuk mencegah diabetes cause of morbidity and mortality among patients with diabetes mellitus DM Increased platelet reactivity among patients with DM contributes to disproportionately high levels of atherothrombotic CVD Consequently there has been tremendous interest in exploring the role of antiplatelet therapies in DM to reduce the development of and frequency of In the 4500 patients with diabetes studied in the ATC the incidence of vascular events was reduced from 235 with control treatment to 193 with antiplatelet therapy P 001 By comparison the lower incidence of vascular events among nearly 42000 nondiabetic patients was reduced from 172 to 137 with antiplatelet therapy P 0 Antiplatelet Therapy in Diabetes Endocrinology and Metabolism Clinics This position is supported by the results of two large metaanalyses of major secondary prevention trials by the Antithrombotic Trialists Collaboration ATC which showed oral antiplatelet agents mostly aspirin to be protective in patients at high risk for cardiovascular disease including those with diabetes 1516 The metaanalyses The Platelet in Diabetes Diabetes Care American Diabetes Association 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 Platelets Coagulation and Antithrombotic Therapy in Diabetes Diabetes and antiplatelet therapy from bench to bedside PMC Oral antiplatelet therapy in diabetes mellitus and the role of In 2002 a metaanalysis 287 trials 135000 participants on the efficacy of antiplatelet therapy in the prevention of major CV events found a clear benefit of aspirin overall 22 risk reduction but no statistically significant benefit in the subgroup of 5126 participants with diabetes artikel diabetes 2018 ppt 7 risk reduction 14 Antiplatelet Therapy in Diabetes Efficacy and Limitations of Current The Optimal Antiplatelet Therapy in Diabetes Mellitus study OPTIMUS evaluated the functional impact of an 150 mg maintenance dose of clopidogrel in diabetics 65 66 Diabetics were randomized to a 75 or 150 mg maintenance dose of clopidogrel Platelet aggregation was significantly reduced with the higher dose However 60 of the diabetics on Current Antiplatelet Treatment Strategy in Patients with Diabetes Antiplatelet Therapy for Every Diabetic Person Diabetes Care Platelet Function in Patients with Diabetes Mellitus From a Antiplatelet therapy in patients with diabetes mellitus Compared to those without diabetes individuals with diabetes are also at increased risk of cardioembolic stroke in the presence of atrial fibrillation AF and of venous thromboembolism Activation of platelets and the coagulation cascade are the central mechanisms of thrombosis A range of antiplatelet and anticoagulant drugs are now available However although currently approved antiplatelet drugs have proved successful in reducing cardiovascular events plateletdependent thrombosis remains an important cause of morbidity and mortality in patients with coronary artery disease It is wellknown that patients with diabetes mellitus DM have an increased risk of cardiovascular events OPTIMUS2 Optimizing antiplatelet therapy in diabetes mellitus 2 2020 DM patients on DAT aspirin 81 mg clopidogrel 75 mg daily Adjunctive Cilostazol 100 mg bd versus placebo 2week crossover doubleblind RCT design Platelet function Enhanced P2Y 12 platelet receptor signaling inhibition with cilostazol in adjunct to standard DAT Diabetes mellitus DM is a metabolic disorder associated with accelerated atherogenesis and an increased risk of atherothrombotic complications Multiple mechanisms contribute to the prothrombotic status which characterizes DM patients underscoring the importance of antiplatelet therapies used for secondary jenis diabetes melitus prevention in these patients
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