Background: Arterial stiffness is a prominent macrovascular complication in patients with type 2 diabetes mellitus (DM2). Antiplatelet therapy is the cornerstone of CVD therapy. There is little evidence about the influence of antiglycemic agents on arterial wall properties and prothrombotic state.

Methods: We enrolled 80 consecutive patients (males=64.4%), aged 64.19 ± 8.82 years receiving either metformin plus another antiglycemic agent such as sulphonylureas, DPP-4i, GLP-1 agonists, insulin, or metformin alone (n=16 per group). Applanation tonometry was used to assess aortic pulse wave velocity (PWV) as a measure of arterial stiffness. Platelet reactivity was measured with PFA-200, collagen/epinephrine (CEPI) and PFA-200 collagen/ADP closure time (CADP).

Results: There was no difference between the study groups regarding gender, age, hypertension, dyslipidemia, smoking, PWV, CADP or CEPI (p=NS for all). When conducting a separate analysis between patients receiving aspirin (AS), dual antiplatelet therapy (DAPT) and those without antiplatelet therapy (nAPT), we observed that nAPT patients exerted significantly lower CEPI values (134.42 ± 40 s for nAPT vs. 170.36 ± 64 s for AS vs. 178.90 ± 74 s for DAPT, p=0.03). PWV was 10.96 ± 2.54 m/s for nAPT vs. 11.20 ± 2.88 m/s for AS vs. 10.82 ± 2.76 m/s for DAPT (p=0.9). Within-group analysis showed that CEPI values were significantly reduced in nAPT under sulphonylureas (121 s vs. 243 s vs. 262 s for nAPT, AS and DAPT respectively, p=0.02) or GLP-1 (138 s vs. 203 s vs. 168 s for nAPT, AS and DAPT respectively, p=0.05). Additionally, we found an inverse, linear association between CEPI and PWV (rho= -0.45, p=0.02) and CADP and PWV (rho= -0.04, p=0.05) in nAPT patients alone.

Conclusion: Increased prothrombotic state is associated with impaired arterial wall elastic properties. Antidiabetic and antiplatelet treatment interactions may regulate the relationship between arterial stiffness and thrombosis in patients with DM2.

Disclosure

G. Siasos: None. P.K. Stampouloglou: None. K. Batzias: None. S.A. Paschou: None. A. Antonopoulos: None. V. Tsigkou: None. N. Gouliopoulos: None. M. Zaromytidou: None. S. Mazaris: None. E. Oikonomou: None. S. Tsalamandris: None. G. Vogiatzi: None. A. Thanopoulou: None. A. Vryonidou: None. M. Politou: None. D. Tousoulis: None. N. Tentolouris: None.

© 2019 by the American Diabetes Association.
2019
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