Many patients with diabetes mellitus show increased platelet aggregation and prostaglandin synthesis m response to adenosine diphosphate (ADP) when their platelets are tested in platelet-rich plasma or washed platelet suspensions.
In this study, the effect of type 2 diabetes on in-vitro platelet aggregation induced by various agonists (ADP, collagen, epinephrine) was investigated in coronary artery disease patients (CAD).
Thirty type 2 diabetes and 40 non-diabetes patients with CAD were studied to investigate the effects of type 2 diabetes mellitus on the response to ADP, collagen and epinephrine induced in-vitro platelet aggregation. Two parameters were used to evaluate the aggregation activity of platelets: the degree of aggregation ratio and aggregation duration. Platelet-rich plasma samples were obtained from the patients, and were treated with in-vitro ADP (10 µmol/L), collagen (0.6 mgm/ml) and epinephrine (20 µmol/L) and platelet aggregation slopes were calculated via the turbidimetric method of Born. The aggregation ratio (%) and the duration (sec.) in the study cases were measured from these slopes and data were compared by the Student's t test. The ratio and duration of platelet aggregation which are induced by agonists were significantly greater in the type 2 diabetes group than the non-diabetic group (p<0.05, p<0.01 for ADP, p<0.05, p<0.05 for collagen and p<0.01 and p<0.05 for epinephrine) respectively.
Agonist-induced in-vitro platelet aggregation response was higher in patients with type 2 diabetes than in non-diabetes. This makes us think that, diabetic CAD patients may need more potent antiplatelet therapy, and blood glucose levels need to be optimally regulated.
Keywords: Type 2 diabetes mellitus, coronary artery disease, platelet aggregation, agonist