The Effect of Type 2 Diabetes Mellitus on Platelet Aggregation in Patients who Underwent Percutaneous Transluminal Coronary Angioplasty

ABSTRACT
In type 2 (NIDDM) diabetic patients it has been expressed that adenosin diphosphate (ADP) triggered platelet aggregation response increases related to a decreased level of platelet guanilate cyclase. Ten patients with type 2 diabetes mellitus and 25 nondiabetic patients who had succesful percutaneous transluminal coronary angioplasty (PTCA) were studied to investigate the effects of type 2 DM on the response of collagen triggered in vitro platelet aggregation in PTCA patients. Platelet rich plasma (PRP) samples from the patients before and after PTCA were treated with in-vitro collagen and platelet aggregation slopes were calculated via the turbidometric method. The activation percentage and the ratio of changes after PTCA in the study cases were measured from these slopes and data were compared by non-parametric methods. Change in collagen induced activation of platelet aggregation in both wave I and wave II was significantly greater (p<0.05) in the type 2 diabetes mellitus group. The ratio of restenosis seen in the control coronary angiography performed 6 months after interventions was found to be significantly higher in the type 2 diabetes mellitus group (p<0.05). Effects of interventions on haematologic parameters (number of platelets, ACT value) were common in both groups. We did not find any significant changes in the left ventricular ejection fraction (LVEF), number of lesions, percent stenosis of arteries before interventions, duration and success of interventions, diameter of balloons used and duration of balloon inflation between groups (p>0.05). In conclusion, collagen induced platelet aggregation response and incidence of thrombosis were greater in patients with type 2 diabetes mellitus than in nondiabetics. This makes us think that type 2 diabetes mellitus patients might need more potent antiplatelet therapy before PTCA after blood glucose levels have been regulated.