Evidence mapPaperPMID 31706305Full record

ArticleCardiovascular diabetology2019

Incremental role of glycaemic variability over HbA1c in identifying type 2 diabetic patients with high platelet reactivity undergoing percutaneous coronary intervention.

Annunziata Nusca, Dario Tuccinardi, Claudio Proscia, Rosetta Melfi, Silvia Manfrini, Antonio Nicolucci, Antonio Ceriello, Paolo Pozzilli, Gian Paolo Ussia, Francesco Grigioni and 1 more

Open access · goldAbstract read
In one paragraph

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.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
5.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.

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  20. Glucose Variability: How Does It Work?International journal of molecular sciences · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 2 countries.

Annunziata NuscaUnit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy. a.nusca@unicampus.it.ORCID 0000-0002-5616-3197
Dario TuccinardiUnit of Endocrinology and Diabetes Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Claudio ProsciaCardiology Department, Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK.
Rosetta MelfiUnit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Silvia ManfriniUnit of Endocrinology and Diabetes Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Antonio NicolucciCardiovascular and Diabetes Department, IRCCS MultiMedica, Sesto San Giovanni, MI, Italy.
Antonio CerielloCardiovascular and Diabetes Department, IRCCS MultiMedica, Sesto San Giovanni, MI, Italy.
Paolo PozzilliUnit of Endocrinology and Diabetes Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Gian Paolo UssiaUnit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Francesco GrigioniUnit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Germano Di SciascioUnit of Cardiac Sciences, Campus Bio-Medico University of Rome, Rome, Italy.
Università Campus Bio-Medico · ITMultiMedica · ITLiverpool Heart and Chest Hospital NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Percutaneous Coronary InterventionAgedBiomarkersBlood GlucoseBlood PlateletsClopidogrelCoronary Artery DiseaseCoronary ThrombosisDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansHypoglycemic AgentsMaleMiddle AgedPlatelet AggregationBiomarkersBlood GlucoseClopidogrelGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic AgentsP2RY12 protein, humanPlatelet Aggregation InhibitorsPurinergic P2Y Receptor AntagonistsReceptors, Purinergic P2Y12Continuous glucose monitoringGlycaemic variabilityGlycated haemoglobinPercutaneous coronary interventionPlatelet reactivity

Identifiers

PMID31706305
PMCPMC6842151
OpenAlexW2984424029

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.