PMID- 28837213
OWN - NLM
STAT- MEDLINE
DCOM- 20180611
LR  - 20181202
IS  - 2567-689X (Electronic)
IS  - 0340-6245 (Linking)
VI  - 117
IP  - 10
DP  - 2017 Oct 5
TI  - Antithrombotic potency of ticagrelor versus clopidogrel in type-2 diabetic 
      patients with cardiovascular disease.
PG  - 1981-1988
LID - 10.1160/TH17-04-0277 [doi]
AB  - Type-2 Diabetes Mellitus [T2DM] is associated with increased platelet reactivity 
      and hypo-response to antiplatelet drugs. Ticagrelor, with its faster and more 
      potent antiplatelet effects, was shown to reduce adverse events more than 
      clopidogrel in the overall CAD patient population of PLATO trial, but the 
      benefits did not reach statistical significance in the T2DM subgroup. To better 
      understand these findings, we compared the antithrombotic effects of ticagrelor 
      versus with clopidogrel in T2DM patients with cardiovascular disease. In a 
      randomized, 2 treatment-sequence, crossover-design, T2DM patients (n=20, 57+/-8 
      years, 60 % male) received a loading-dose [LD] plus one week of daily-therapy 
      [DT] of clopidogrel or ticagrelor. Treatment effects were assessed by measuring 
      thrombus formation (Badimon Chamber) and platelet aggregation (Multiple Electrode 
      Aggregometry (MEA) Analyzer and VerifyNow(R)) at 2- and 6-hour post-LD and on Day-7 
      of DT, in comparison with pre-treatment baseline. After 2 weeks of washout, 
      patients switched to the second treatment under identical testing conditions. 
      Ticagrelor significantly reduced thrombus formation versus baseline at 2- and 
      6-hour post-LD and Day-7 of DT (33 %, 40 % and 31 %, respectively, p<0.01 for 
      all) whereas thrombus reductions with clopidogrel were much lower and significant 
      only at 6-hour post-LD (16 %, 20 % and 17 %, respectively). Antithrombotic effect 
      of ticagrelor at 6-hour was significantly stronger than clopidogrel (p<0.05). 
      Platelet aggregation (MEA and VerifyNow(R)) was inhibited by both treatments but 
      effects of ticagrelor were significantly stronger at each time-point. Ticagrelor 
      exhibits a faster and more potent antithrombotic effect than clopidogrel in T2DM 
      patients with cardiovascular disease, supporting its use in this population.
FAU - Zafar, M Urooj
AU  - Zafar MU
FAU - Baber, Usman
AU  - Baber U
FAU - Smith, Donald A
AU  - Smith DA
FAU - Sartori, Samantha
AU  - Sartori S
FAU - Contreras, Johanna
AU  - Contreras J
FAU - Rey-Mendoza, Juan
AU  - Rey-Mendoza J
FAU - Linares-Koloffon, Carlos A
AU  - Linares-Koloffon CA
FAU - Escolar, Gines
AU  - Escolar G
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Fuster, Valentin
AU  - Fuster V
FAU - Badimon, Juan J
AU  - Badimon JJ
LA  - eng
SI  - ClinicalTrials.gov/NCT01823510
GR  - UL1 TR000067/TR/NCATS NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20170824
PL  - Germany
TA  - Thromb Haemost
JT  - Thrombosis and haemostasis
JID - 7608063
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - GLH0314RVC (Ticagrelor)
RN  - K72T3FS567 (Adenosine)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Adenosine/administration & dosage/adverse effects/*analogs & derivatives
MH  - Aged
MH  - Blood Platelets/*drug effects/metabolism
MH  - Cardiovascular Diseases/blood/complications/diagnosis/*drug therapy
MH  - Clopidogrel
MH  - Coronary Thrombosis/blood/diagnosis/etiology/*prevention & control
MH  - Cross-Over Studies
MH  - Diabetes Mellitus, Type 2/blood/*complications/diagnosis
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage/adverse effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/*administration & dosage/adverse effects
MH  - Platelet Function Tests
MH  - Ticagrelor
MH  - Ticlopidine/administration & dosage/adverse effects/*analogs & derivatives
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Antiplatelet agents
OT  - clopidogrel
OT  - diabetes mellitus
OT  - thrombosis
OT  - ticagrelor
EDAT- 2017/08/25 06:00
MHDA- 2018/06/12 06:00
CRDT- 2017/08/25 06:00
PHST- 2017/04/21 00:00 [received]
PHST- 2017/06/26 00:00 [accepted]
PHST- 2017/08/25 06:00 [pubmed]
PHST- 2018/06/12 06:00 [medline]
PHST- 2017/08/25 06:00 [entrez]
AID - 17-04-0277 [pii]
AID - 10.1160/TH17-04-0277 [doi]
PST - ppublish
SO  - Thromb Haemost. 2017 Oct 5;117(10):1981-1988. doi: 10.1160/TH17-04-0277. Epub 
      2017 Aug 24.