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January 1, 2016Circulation JournalOpen Access

Antithrombotic Therapy for Secondary Prevention in Patients With Diabetes Mellitus and Coronary Artery Disease

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This review aims to evaluate the efficacy of antithrombotic therapies for secondary prevention of recurrent atherothrombotic events in patients with diabetes mellitus following acute coronary syndrome or PCI.
Review of recent advances in oral antithrombotic agents
Focus on dual antiplatelet therapy and alternative antithrombotic strategies
Consideration of new anticoagulants and their roles in treatment regimens
Despite using standard dual antiplatelet therapy, recurrence rates of atherothrombotic events remain high in patients with diabetes mellitus.
Newer medications like prasugrel and ticagrelor show promise for better platelet inhibition.
The reappraisal of anticoagulants presents additional options for secondary prevention in patients with diabetes.

Structured PICO

Population

Patients with diabetes mellitus (DM) and coronary artery disease (CAD) following acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI)

Intervention

Oral antithrombotic therapy (including potent P2Y12 inhibitors like prasugrel and ticagrelor, vorapaxar, and target-specific oral anticoagulants)

Outcome

Secondary prevention of recurrent atherothrombotic events

This review emphasizes the need for more potent antithrombotic strategies beyond standard clopidogrel-based DAPT to reduce the high rate of recurrent atherothrombotic events in patients with diabetes following ACS or PCI.

Discussion

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Implication

May support testing potent P2Y12 inhibitors or anticoagulants in DM post-ACS; leaves open optimal regimen pending dedicated RCTs.

Cite This Study

Park et al. (2016) studied this question.

synapsesocial.com/papers/6a086962280cd4e998e8bbdf https://doi.org/10.1253/circj.cj-16-0208

Topics

Coronary artery disease

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Antithrombotic Therapy for Secondary Prevention in Patients With Diabetes Mellitus and Coronary Artery Disease

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Antithrombotic Therapy for Secondary Prevention in Patients With Diabetes Mellitus and Coronary Artery Disease

Key Points

Structured PICO

Discussion

Implication

Cite This Study

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