Comparison of clopidogrel antiplatelet activity in diabetic versus nondiabetic patients with acute coronary syndromes and patients undergoing elective stent placement / Mina Wageh Mohareb ; Supervised Samar Farid , Nermeen Ahmed Sabry , Mohamed Abd Elghany Karim

Thesis (M.Sc.) - Cairo University - Faculty of Pharmacy - Department of Pharmaceutics

High platelet reactivity (HPR) and suboptimal response to dual antiplatelet therapy (DAPT) may explain high recurrent rates of ischemic events in Type I and II diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). The aim of this study was to determine the effect of diabetes mellitus on clopidogrel activity in cardiac patients undergoing PCI. Patients and methods This is an observational study. Patients were categorized according to DM status into diabetic group (N= 30) and non-diabetic group (N=33).All patients received clopidogrel-loading dose of 600 mg before PCI. Platelet function was assessed using light transmittance aggregometry (LTA) technique at base line(before clopidogrel loading administration), 24 hour after clopidogrel loading dose administration and 7-10 days after PCI. All patients were followed up for at least one year after PCI for recurrence of acute cardiac events. Results There was no statistically significant difference between diabetic and non-diabetic groups with respect to 10 æm adenosine di-phosphate (ADP) induced platelet aggregation - measured at base line(P=0.64), 24 hr after PCI (P=0.874) and 7-10 days after PCI(0.643).Diabetics were non-significantly different from non-diabetics regarding post-PCI acute stent thrombosis (P=0.945),sub-acute stent thrombosis (P=0.945), unstable angina(P=0.29) and cardiac death (P=0.64).There was statistically significant difference between patients with and without post-PCI acute events regarding ADP aggregation measured 24 hr and 7-10 days after PCI

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