Diabetics with coronary syndrome face clot risk

Patients with type-2 diabetes and acute coronary syndrome (ACS) suffer from larger blood clots that embolise more easily, UK research suggests.

Clotting: action measured (Photograph: National Cancer Institute / Science Photo Library)

Researchers from Newcastle University believe the findings explain why diabetic patients are at increased risk of thrombotic events even when treated with dual anti-platelet therapy.

Lead author Girish Viswanathan presented the research at the Diabetes UK conference.

His team recruited 60 patients who had had troponin-positive non-ST elevation acute coronary syndrome, half of whom were diabetic. All patients received 300mg loading and 75mg daily dose of aspirin and clopidogrel.

Researchers measured the size of clot formation using a Badimon chamber. This uses a flow of blood to simulate the in vivo situation of high shear arterial wall damage in an external chamber. Clot kinetics were studied in a subgroup of 13 patients with diabetes and 10 without, to see how easily patients' clots would break free from the arterial lining in vivo. They found that clot area was higher in patients with diabetes.

Dr Viswanathan said: 'The results support the need for individualised anti-thrombotic therapy in type-2 diabetes mellitus.'

He added that inflammation may play a greater role than glycaemia in raising the threat of thrombotic events in this group.

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