Differences between Platelet Immature Levels in Diabetes Mellitus Compared to Non Diabetes Mellitus Patients with Stable Coronary Artery Disease

Author : D.R. Balti, Andrianto, B. Baktijasa
Upload Date : 19-04-2018

Background: Coronary Artery Disease (CAD) remains as one of the leading cause of global mortality, morbidity  and  major economic burden on health care systems. The known pathophysiology of intravascular thrombus formation in CAD is platelet activation. The circulating platelets itself is not homogeneous. Immature platelets, or reticulated platelets (RPs) are the youngest component of the circulating platelet which is metabolically more active. Compared to normal mature platelets, they have higher thrombotic potential  and  less responsive to antiplatelet drugs.Studies shown that diabetic patients often display a higher platelet reactivity and more suboptimal response to antiplatelet therapy. This proposed to weather CAD patients with diabetes mellitus have higher immature platelets level, which  measured by the absolute count of immature platelet count [IPC] and the fraction of the total platelet pool or immature plateletfraction [IPF] compared to CAD patients without diabetes mellitus.

Method: Observational analytics using cross sectional.

Results: There is a difference in IPF and IPC level between DM and non-DM, but it is not statistically significant. It may be because many subjects with DM  have regulated glycemic index. There is a strong, positive, and significant correlation between HbA1C and IPF, as increases in A1c were accompanied by increases in immature platelet. Clopidogrel (β -0.576; p 0.01) has stronger negative correlations with IPF than aspilet (β -0.098; p 0.926).

Conclusion: There is different immature platelet level between diabetic patients with non diabetic patients. Patients with higher HbA1C have higher immature platelet level. We found that clopidogrel has negative correlations with immature platelet level, as in patients who consume it had lower immature platelet level. Patients with high immature platelet level were suggested to choose a more reversible and longer halftime antiplatelet.

KEYWORDS : Immature Platelet, Diabetes Mellitus, Non Diabetes Mellitus, Stable Coronary Heart Disease

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