PMID- 24582462
OWN - NLM
STAT- MEDLINE
DCOM- 20150414
LR  - 20211021
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Print)
IS  - 0049-3848 (Linking)
VI  - 133
IP  - 5
DP  - 2014 May
TI  - Differences in thrombus structure and kinetics in patients with type 2 diabetes 
      mellitus after non ST elevation acute coronary syndrome.
PG  - 880-5
LID - S0049-3848(14)00057-7 [pii]
LID - 10.1016/j.thromres.2014.01.033 [doi]
AB  - INTRODUCTION: Despite optimal secondary prevention therapy following non-ST 
      elevation acute coronary syndrome (NSTE-ACS), recurrent thrombotic events are 
      more frequent in patients with type 2 diabetes mellitus (T2DM). MATERIALS AND 
      METHODS: This exploratory study was aimed to evaluate quantitative and 
      qualitative aspects of thrombus. In 28 patients with and without T2DM treated 
      with aspirin and clopidogrel we assessed thrombus quantity using an ex-vivo 
      chamber, platelet reactivity, thrombus ultrastructure and thrombus kinetics one 
      week after NSTE-ACS. RESULTS: T2DM was associated with increased thrombus [14861 
      (8003 to 30161) vs 8908 (6812 to 11996), mu(2)/mm, median (IQR), p=0.045] and 
      platelet reactivity. In addition, diabetic thrombus showed lower visco-elastic 
      tensile strength [(-0.2(-1.7 to 0.7) vs 1.0(-0.9 to 3.3), p=0.044)] and was more 
      resistant to autolysis [(27.8(11.7 to 70.7) vs 78.8(68.5 to109.6) mm/min, 
      p=0.002)]. On SEM, fibrin fibres in diabetes were thinner, with higher lateral 
      interlinkage and mesh-like organisation. Thrombus quantity correlated inversely 
      with thrombus retraction (r=-0.450 p=0.016) but not with platelet reactivity 
      (r=0.153, p=0.544). CONCLUSIONS: Despite optimal antiplatelet therapy, T2DM 
      patients after NSTE-ACS developed increased thrombus of lower tensile strength 
      and slower retraction. SEM revealed loosely arranged fibrin fibres. Our data 
      showed significant differences in the magnitude as well as structural and 
      mechanistic characteristics of thrombus in patients with T2DM.
CI  - Copyright (c) 2014. Published by Elsevier Ltd.
FAU - Viswanathan, Girish N
AU  - Viswanathan GN
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. 
      Electronic address: Girish.viswanathan@newcastle.ac.uk.
FAU - Marshall, Sally M
AU  - Marshall SM
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. 
      Electronic address: s.m.marshall@newcastle.ac.uk.
FAU - Balasubramaniam, Karthik
AU  - Balasubramaniam K
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK. 
      Electronic address: karthik.balasubramaniam@newcastle.ac.uk.
FAU - Badimon, Juan J
AU  - Badimon JJ
AD  - The Mount Sinai School of Medicine, NY, USA. Electronic address: 
      juan.badimon@mssm.edu.
FAU - Zaman, Azfar G
AU  - Zaman AG
AD  - Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK; 
      Freeman Hospital, Newcastle upon Tyne, UK. Electronic address: 
      Azfar.zaman@nuth.nhs.uk.
LA  - eng
GR  - FS/033/07/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140201
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Acute Coronary Syndrome/*blood/drug therapy/pathology
MH  - Aged
MH  - Aspirin/therapeutic use
MH  - Clopidogrel
MH  - Diabetes Mellitus, Type 2/*blood/drug therapy/pathology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - Thrombosis/*blood/*pathology
MH  - Ticlopidine/analogs & derivatives/therapeutic use
PMC - PMC4018991
OTO - NOTNLM
OT  - Antiplatelet therapy
OT  - Fibrin structure
OT  - Non ST elevation acute coronary syndrome
OT  - Thrombus kinetics
OT  - Type 2 diabetes mellitus
OT  - Whole blood thrombus
EDAT- 2014/03/04 06:00
MHDA- 2015/04/15 06:00
PMCR- 2014/05/01
CRDT- 2014/03/04 06:00
PHST- 2013/10/16 00:00 [received]
PHST- 2013/12/27 00:00 [revised]
PHST- 2014/01/27 00:00 [accepted]
PHST- 2014/03/04 06:00 [entrez]
PHST- 2014/03/04 06:00 [pubmed]
PHST- 2015/04/15 06:00 [medline]
PHST- 2014/05/01 00:00 [pmc-release]
AID - S0049-3848(14)00057-7 [pii]
AID - 10.1016/j.thromres.2014.01.033 [doi]
PST - ppublish
SO  - Thromb Res. 2014 May;133(5):880-5. doi: 10.1016/j.thromres.2014.01.033. Epub 2014 
      Feb 1.