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What is the most effective and safe antiplatelet therapeutic strategy in diabetic patients with coronary artery disease?
What is the most effective and safe antiplatelet therapeutic strategy in diabetic patients with coronary artery disease?
This review discusses the evidence for using more potent antiplatelet strategies (prasugrel, ticagrelor, or high-dose clopidogrel) to overcome impaired antiplatelet responsiveness in diabetic patients with coronary artery disease.
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Hypothesis-generating for intensified antiplatelet regimens in diabetes; leaves open optimal agent and dosing in ACS/PCI.
Diabetes mellitus is characterized by enhanced platelet reactivity and impaired response to antiplatelet therapy, with a higher percentage of low responders and an increased risk of thrombotic events following an acute coronary syndrome and/or percutaneous coronary intervention. This evidence was utilized to investigate the effectiveness and safety of higher doses of clopidogrel as well as the use of newer and more potent antiplatelet drugs, such as prasugrel and ticagrelor, in this highrisk subset of patients. The aim of this paper is to systematically report the latest evidence on the prognostic role of diabetes mellitus on responsiveness to antiplatelet treatments and to discuss the most effective therapeutic strategy to be used in such patients.
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Proscia et al. (2015) studied this question.
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