Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control

Osende, Julio I.; Badimón, Juan J.; Fuster, Valentín; Herson, Perry; Rabito, Phil; Vidhun, Ramapriya; Zaman, Azfar; Rodríguez, O; Lev, Eli I.; Rauch, Ursula; Heflt, Gerard; Fallon, John T.; Crandall, Jill P.

doi:10.1016/s0735-1097(01)01555-8

Cited by 150 publications

(95 citation statements)

References 25 publications

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“…In vitro induced thrombin generation is increased in platelet-rich plasma from diabetics compared with that from healthy subjects and a significant elevation of thrombin levels can be demonstrated in T2D patients in poor metabolic control when compared with well controlled patients [6]. Moreover, a significant correlation can be observed between improved glycemic control and blood thrombogenicity, as reflected by a reduction in ex-vivo thrombus formation in a Badimon perfusion chamber [7]. Improved glycemic control is the only significant predictor of a decrease in blood thrombogenicity, irrespective of treatment allocation [7].…”

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confidence: 95%

“…Moreover, a significant correlation can be observed between improved glycemic control and blood thrombogenicity, as reflected by a reduction in ex-vivo thrombus formation in a Badimon perfusion chamber [7]. Improved glycemic control is the only significant predictor of a decrease in blood thrombogenicity, irrespective of treatment allocation [7]. Enhanced levels of prothrombin fragment 1+2 (F1+2) and thrombin-antithrombin complexes (TAT) have been shown in T2D patients in comparison with healthy subjects [8].…”

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confidence: 99%

“…Similarly to T2D, dyslipidemia has been associated with altered coagulation leading to an increased risk of hypercoagulability through mechanisms linked to insulin resistance [7]. However, the mechanisms linking dyslipidemia, hyperglycemia and hypercoagulability are complex and to date have been only partially delineated (Fig.…”

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confidence: 99%

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Beyond Hyperglycemia in Diabetes: Role of Statin Treatment on Thrombogenesis Triggered by Inflammation

Perego

Davı̀

2012

Cardiovasc Drugs Ther

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Type 2 diabetes mellitus (T2D) constitutes a growing global public health problem and its prevalence is estimated to increase during the next decades, especially in the developing countries. To date, 15 % of the whole population is considered at high risk to develop T2D [1]. T2D is associated with a decrease of health-related quality of life and overall life expectancy, mainly due to an increased risk for cardiovascular disorders. Indeed, T2D is commonly associated with both microvascular and macrovascular complications [2]. Macrovascular complications manifest themselves as accelerated atherosclerosis, clinically resulting in premature coronary artery disease, increased risk of cerebrovascular disease, and severe peripheral vascular disease [2]. Patients with T2D have a a two-to four-fold increase in the risk of coronary artery disease (CAD) and patients with DM but without previous myocardial infarction (MI) carry the same level of risk for subsequent acute coronary events as non-diabetic patients with previous MI [3,4] so that T2D has been defined a CAD equivalent.T2D is associated with a prothrombotic state characterized by a number of changes in thrombotic and fibrinolytic coagulation factor level/activity, which together increase the risk of thrombus formation. Both glucose and insulin seem to play a role in the pathogenesis of this prothrombotic state [5]. In vitro induced thrombin generation is increased in platelet-rich plasma from diabetics compared with that from healthy subjects and a significant elevation of thrombin levels can be demonstrated in T2D patients in poor metabolic control when compared with well controlled patients [6]. Moreover, a significant correlation can be observed between improved glycemic control and blood thrombogenicity, as reflected by a reduction in ex-vivo thrombus formation in a Badimon perfusion chamber [7]. Improved glycemic control is the only significant predictor of a decrease in blood thrombogenicity, irrespective of treatment allocation [7]. Enhanced levels of prothrombin fragment 1+2 (F1+2) and thrombin-antithrombin complexes (TAT) have been shown in T2D patients in comparison with healthy subjects [8].A hypercoagulable state, detected by thrombin generation tests, was reported in patients with T2D, explaining, at least partially, the high incidence of vascular events in these patients [9].Platelets of patients with DM are characterized by dysregulation of several signaling pathways, leading to an hyperreactive phenotype with enhanced adhesion, aggregation, and activation [10]. Chronic hyperglycemia has been clearly identified as a causal factor for in vivo platelet activation [11]. Our group firstly demonstrated enhanced thromboxane (TX) biosynthesis in T2D, providing evidence for its platelet origin. Moreover, tight metabolic control led to reduction of TX metabolite urinary levels [11]. Interestingly, inflammatory mediators (such as CD40L) derived from platelets expand the functional repertoire of platelets from players of hemostasis and thrombosis to powerful a...

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Beyond Hyperglycemia in Diabetes: Role of Statin Treatment on Thrombogenesis Triggered by Inflammation

Perego

Davı̀

2012

Cardiovasc Drugs Ther

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“…26 Thiazolidinediones hold promise for other reasons as well, including their ability to impart favorable changes in the vascular endothelium, reduce cytokine production by proatherogenic macrophages, and possibly lower blood thrombogenicity. 27,28 Metformin also remains a commonly used agent to treat patients with type 2 diabetes. It reduces insulin resistance, inhibits prothrombotic factor activity, and enhances lipoprotein metabolism in diabetic and insulin-resistant nondiabetic patients.…”

Section: Blood Glucose Managementmentioning

confidence: 99%

Evolving targets for risk reduction in diabetes

Caputo

Braunstein

Blumenthal

2004

Clinical Cardiology

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Summary: Recent evidence shows that target low-density lipoprotein cholesterol should be less than 100 mg/dl in patients with diabetes, and that even those with initially low levels benefit from pharmacologic therapy. Recent studies document that blood pressures lower than the previous target of 140/90 mmHg are beneficial, in addition to providing observational evidence against a lower threshold of benefit. Evidence that addresses the effect of blood glucose on macrovascular disease risk in patients with diabetes is reviewed. Finally, recommendations are made regarding systematic changes in healthcare delivery that will facilitate risk reduction strategies in diabetes.

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“…It has been reported that diabetes patients exhibit higher levels of pro-coagulant factors such as the Von Willebrand factor, fibrinogen (FIB) and factor VII (10). Thrombin is also significantly increased in type 2 diabetes mellitus (T2DM), especially in patients with poor metabolic control, and improvement of glycemic control is associated with a reduction of thrombin generation (11). Apart from these procoagulant changes, T2DM is also characterized by the reduction of several anticoagulant proteins such as protein C and antithrombin III (12).…”

Section: Introductionmentioning

confidence: 99%

Influence of type 2 diabetes mellitus on Khorana venous thromboembolism risk in colorectal cancer patients

Wang

Zhao

et al. 2017

Rev Esp Enferm Dig

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Background: Many studies have documented the association between venous thromboembolism (VTE) and colorectal cancer (CRC). The Khorana model is a VTE risk assessment model for predicting cancer-associated thrombosis. Type 2 diabetes (T2DM) has also been reported to increase the risk of VTE.Purpose: The aim of this study was to investigate the influence of T2DM on Khorana VTE risk in CRC patients and to explore the relationship between Khorana VTE category and CRC clinicopathological factors.Methods: This analysis included 615 CRC patients (205 with T2DM). Fibrinogen and D-dimer levels were compared within each group. A comparison was made of the proportion of patients in different Khorana VTE risk categories in CRC patients with and without T2DM. The association between Khorana VTE risk category and clinicopathological factors among all the CRC patients was evaluated.Results: Fibrinogen levels of CRC patients with T2DM were significantly higher than those of non-diabetes patients (4.13 ± 1.06 vs 3.94 ± 0.98, p < 0.001

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Blood thrombogenicity in type 2 diabetes mellitus patients is associated with glycemic control

Abstract: In T2DM, there is an association between improved glycemic control and blood thrombogenicity reduction. The effect of glycemic control on the thrombotic complications of T2DM patients deserves further investigation.

Cited by 150 publications

References 25 publications

Beyond Hyperglycemia in Diabetes: Role of Statin Treatment on Thrombogenesis Triggered by Inflammation

Beyond Hyperglycemia in Diabetes: Role of Statin Treatment on Thrombogenesis Triggered by Inflammation

Evolving targets for risk reduction in diabetes

Influence of type 2 diabetes mellitus on Khorana venous thromboembolism risk in colorectal cancer patients

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