What question did this study set out to answer?

To determine whether twice-daily aspirin dosing provides more effective platelet inhibition than once-daily dosing in patients with type 2 diabetes mellitus and stable coronary artery disease.

March 9, 2011Circulation Cardiovascular Interventions

Pharmacodynamic Effects of Different Aspirin Dosing Regimens in Type 2 Diabetes Mellitus Patients With Coronary Artery Disease

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Why the study?

Does twice-daily aspirin dosing improve platelet inhibition compared to once-daily dosing in patients with type 2 diabetes mellitus and stable coronary artery disease?

Key Points

To determine whether twice-daily aspirin dosing provides more effective platelet inhibition than once-daily dosing in patients with type 2 diabetes mellitus and stable coronary artery disease.
Prospectively enrolled 20 patients with type 2 diabetes mellitus and stable coronary artery disease (NCT01201785).
Assessed five weekly sequential aspirin dosing regimens: 81 mg once daily, 81 mg twice daily, 162 mg once daily, 162 mg twice daily, and 325 mg once daily.
Evaluated platelet reactivity via light-transmittance aggregometry (using arachidonic acid, collagen, and ADP stimuli), the VerifyNow-Aspirin assay, and serum thromboxane B2 levels.
Escalating once-daily aspirin doses up to 325 mg did not significantly reduce platelet reactivity on collagen-induced aggregation or VerifyNow-Aspirin assays.
Twice-daily dosing (81 mg twice daily and 162 mg twice daily) significantly reduced platelet reactivity compared to 81 mg once daily on both collagen-induced aggregation and VerifyNow-Aspirin assays (P < 0.05 for both).
Serum thromboxane B2 levels exhibited a significant dose-dependent reduction across regimens (P = 0.003), while adenosine diphosphate-induced aggregation remained unaffected.

Structured PICO

Does twice-daily aspirin dosing improve platelet inhibition compared to once-daily dosing in patients with type 2 diabetes mellitus and stable coronary artery disease?

Population

20 patients with type 2 diabetes mellitus (T2DM) and stable coronary artery disease

Intervention

Aspirin administered twice daily (81 mg/bid or 162 mg/bid) modified on a weekly basis

Comparator

Aspirin administered once daily (81 mg/od, 162 mg/od, or 325 mg/od)

Outcome

Platelet reactivity assessed by light-transmittance aggregometry (arachidonic acid, collagen, and adenosine diphosphate stimuli), VerifyNow-Aspirin assay, and serum thromboxane B2 (TXB2) levelssurrogate

In patients with T2DM and stable CAD, twice-daily low-dose aspirin provides more effective platelet inhibition than once-daily dosing.

Discussion

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Implication

Twice-daily low-dose aspirin may enhance platelet inhibition in T2DM with stable CAD; leaves open effects on clinical outcomes.

Cite This Study

Capodanno et al. (2011) studied this question.

synapsesocial.com/papers/6a701e74f44fa9f079dda8d9 https://doi.org/10.1161/circinterventions.110.960187

Topics

Dual antiplatelet therapy Coronary artery disease

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