Abstract 14554: Effect of Periprocedural Glycemic Control on Platelet Activity in Patients with Type 2 Diabetes Mellitus Undergoing Coronary Angiography
Background: Peri-procedural hyperglycemia is independently associated with mortality in patients undergoing PCI, but the mechanism is unknown. We aim to explore the association between diabetes, peri-procedural hyperglycemia and platelet activity, as well as to evaluate the effects of continuing long-acting hypoglycemic medications in diabetic patients prior to coronary angiography on markers of platelet activity.
Methods: Among 351 patients randomized in the Peri-procedural Glycemic Control in Patients Undergoing Coronary Angiography trial, 75 patients were enrolled in the pre-specified platelet sub study. Platelet activity was measured at procedural access in 50 diabetic patients (25 randomized to continue and 25 randomized to hold their long-acting hypoglycemic medications prior to coronary angiography) and 25 non-diabetic controls. Leukocyte (LPA) and monocyte platelet aggregates (MPA) were determined using flow cytometry; soluble p-selectin was measured using ELISA. Data are presented as median [interquartile range]. Intergroup and continue versus hold comparisons were made using Kruskal-Wallis and Mann-Whitney tests, respectively.
Results: Age, sex, race and anti-platelet medications were similar across the three groups. Overall, diabetic patients had higher platelet activity than non-diabetic patients. Furthermore, diabetic patients randomized to the Continue group demonstrated lower glucose, LPA and MPA than those in the Hold group.
Conclusions: Diabetic patients have increased platelet activity at the time of coronary angiography. Routinely continuing long-acting hypoglycemic medications in diabetic patients prior to coronary angiography helps achieve euglycemia and reduces platelet activity at the time of procedure.
- © 2012 by American Heart Association, Inc.