ArticleCardiovascular diabetology2019
Incremental role of glycaemic variability over HbA1c in identifying type 2 diabetic patients with high platelet reactivity undergoing percutaneous coronary intervention.
Article in Cardiovascular diabetology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Acute glycemic variability on admission predicts the prognosis in hospitalized patients with coronary artery disease: a meta-analysis.Endocrine · 2020Pooled it
- Empagliflozin reduced long-term HbA1c variability and cardiovascular death: insights from the EMPA-REG OUTCOME trial.Cardiovascular diabetology · 2020Trial
- High on-clopidogrel platelet reactivity among diabetic female patients with acute ischaemic stroke.Scientific reports · 2026Article
- Predictors of 12-Month MACE Among Diabetic, Prediabetic, and Normoglycemic Patients Undergoing Elective Percutaneous Coronary Intervention: 10 Years' Experience From Tehran Heart Center.Health science reports · 2026Article
- Hypoglycemia and glycemic variability in acute myocardial infarction: the lesser-known aspects of glycemic control.Cardiovascular diabetology · 2025Review
- Long-Term Outcomes Following Percutaneous Coronary Intervention With Rotational Atherectomy for Severely Calcified Lesions.Circulation reports · 2025Article
- Article
- Effect of Beta-Cell Function on Glucose Variability When Switching From Insulin Degludec Plus a Dipeptidyl Peptidase-4 Inhibitor to Insulin Degludec/Liraglutide: Preliminary Results From a Pilot Study.International journal of endocrinology · 2025Article
- Diabetic cardiomyopathy and COVID-19: intersecting pathways and amplified cardiovascular risk.Frontiers in pharmacology · 2025Review
- Impact of haemoglobinA1c on platelet reactivity and cardiovascular outcomes in patients undergoing drug-eluting stent implantation.Scientific reports · 2024Article
- Short-term Glycemic Variability and Its Association With Macrovascular and Microvascular Complications in Patients With Diabetes.Journal of diabetes science and technology · 2024Review
- Research progress on the association between glycemic variability index derived from CGM and cardiovascular disease complications.Acta diabetologica · 2024Review
- Analyzing the non-linear relationship between fasting blood glucose levels and Gensini score in patients with STEMI.Frontiers in cardiovascular medicine · 2024Article
- Association of ADP-Induced Whole-Blood Platelet Aggregation with Serum Low-Density Lipoprotein Cholesterol in Patients with Coronary Artery Disease When Receiving Maintenance Ticagrelor-Based Dual Antiplatelet Therapy.Journal of clinical medicine · 2023Article
- The Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors Reduce Platelet Activation and Thrombus Formation by Lowering NOX2-Related Oxidative Stress: A Pilot Study.Antioxidants (Basel, Switzerland) · 2022Article
- Glycaemic Control in Patients Undergoing Percutaneous Coronary Intervention: What Is the Role for the Novel Antidiabetic Agents?International journal of molecular sciences · 2022Review
- Associations of hypoglycemia, glycemic variability and risk of cardiac arrhythmias in insulin-treated patients with type 2 diabetes: a prospective, observational study.Cardiovascular diabetology · 2021Observational
- Visit-to-visit fasting blood glucose variability and lifetime risk of cardiovascular disease: a prospective study.Cardiovascular diabetology · 2021Observational
- The role of T-cell immunity in COVID-19 severity amongst people living with type II diabetes.The FEBS journal · 2021Review
- Glucose Variability: How Does It Work?International journal of molecular sciences · 2021Review
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetic patients with on-treatment high platelet reactivity (HPR) show an increased risk of thrombotic events. Whether measuring glycated haemoglobin (HbA1c) levels and/or glycaemic variability (GV) may help identifying diabetic patients at higher risk deserving tailored antiplatelet and/or glucose lowering strategies is unknown. We aimed to investigate the relationship between GV, HbA1c levels and platelet reactivity in patients with type 2 diabetes mellitus (DM) undergoing percutaneous coronary intervention (PCI).
methodsPlatelet reactivity was measured in type 2 DM patients using VerifyNow P2Y12 assay. HPR was defined as P2Y12 Reaction Unit (PRU) > 240. GV was expressed through mean amplitude of glycaemic excursions (MAGE) and coefficient of variance (CV) by using the iPro™ continuous glucose recorder.
resultsThirty-five patients (age 70 ± 9 years, 86% male, mean HbA1c 7.2 ± 1.0%) on clopidogrel therapy were enrolled. HbA1c was independently associated with HPR (OR 7.25, 95% CI 1.55-33.86, p = 0.012). Furthermore, when factored into the model, GV indexes provided independent (OR 1.094, 95% CI 1.007-1.188, p < 0.034) and additional (p < 0.001) diagnostic significance in identifying diabetic patients with HPR.
conclusionsGlyco-metabolic state significantly correlates with HPR in well-controlled type 2 DM patients on clopidogrel therapy. HbA1c identifies patients at higher thrombotic risk but the highest diagnostic accuracy is achieved by combining GV and HbA1c. Whether individualized antithrombotic and glucose-lowering therapies based on the assessment of these parameters may reduce the incidence of thrombotic events in patients undergoing PCI should be further investigated.
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