Comparison of increased aspirin dose versus combined aspirin plus clopidogrel therapy in patients with diabetes mellitus and coronary heart disease and impaired antiplatelet response to low-dose aspirin

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dc.contributor.authorDuzenli, Mehmet Akif
dc.contributor.authorOzdemir, Kurtulus
dc.contributor.authorAygul, Nazif
dc.contributor.authorSoylu, Ahmet
dc.contributor.authorTokae, Mehmet
dc.date.accessioned2020-03-26T17:26:32Z
dc.date.available2020-03-26T17:26:32Z
dc.date.issued2008
dc.departmentSelçuk Üniversitesien_US
dc.description.abstractThe effects of therapy with aspirin 300 mg/day and with combined aspirin 100 mg/day plus clopidogrel 75 mg/day on platelet function were compared in patients with diabetes mellitus and coronary artery disease and impaired antiplatelet responses to aspirin 100 mg/day. The study population consisted of 151 outpatients with type 11 diabetes mellitus and coronary artery disease who were taking aspirin 100 mg/day. Of the 151 patients, a subgroup of subjects with impaired aspirin response were selected on the basis of the results of platelet aggregometry. Nonresponsiveness to aspirin was defined as mean aggregation >= 69% with 3 mu mol/L adenosine diphosphate and mean aggregation >= 70% with 2 mu mol/L collagen. Aspirin semiresponders were defined as meeting I but not both of these criteria. Nonresponders and semiresponders were randomized equally to aspirin 300 mg/day and aspirin 100 mg/day plus clopidogrel 75 mg/day, and aggregation tests were repeated after 2 weeks. Sixty of the 151 patients with diabetes (40%) were found to respond to aspirin inadequately. Platelet aggregation induced by adenosine diphosphate and collagen decreased significantly after aspirin 300 mg/day or combined therapy. Combined treatment was found to have a stronger inhibitory effect on platelet aggregation induced by adenosine diphosphate than aspirin 300 mg/day (p = 0.002). Impaired aspirin response was resolved by increasing the aspirin dose or adding clopidogrel to aspirin (p < 0.0001 for each). However, desired platelet inhibition was achieved in significantly more patients by combined treatment than by aspirin 300 mg/day (p < 0.05). In conclusion, aspirin 100 mg/day does not inhibit platelet function adequately in a significant number of patients with diabetes mellitus and coronary artery disease. Increasing the aspirin dose to 300 mg/day or adding clopidogrel to aspirin can provide adequate platelet inhibition in a significant number of those patients with impaired responses to low-dose aspirin. (C) 2008 Elsevier Inc. All rights reserved.en_US
dc.identifier.doi10.1016/j.amjcard.2008.03.074en_US
dc.identifier.endpage400en_US
dc.identifier.issn0002-9149en_US
dc.identifier.issn1879-1913en_US
dc.identifier.issue4en_US
dc.identifier.pmid18678294en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage396en_US
dc.identifier.urihttps://dx.doi.org/10.1016/j.amjcard.2008.03.074
dc.identifier.urihttps://hdl.handle.net/20.500.12395/22269
dc.identifier.volume102en_US
dc.identifier.wosWOS:000258848000005en_US
dc.identifier.wosqualityQ1en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherEXCERPTA MEDICA INC-ELSEVIER SCIENCE INCen_US
dc.relation.ispartofAMERICAN JOURNAL OF CARDIOLOGYen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.selcuk20240510_oaigen_US
dc.titleComparison of increased aspirin dose versus combined aspirin plus clopidogrel therapy in patients with diabetes mellitus and coronary heart disease and impaired antiplatelet response to low-dose aspirinen_US
dc.typeArticleen_US

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