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Bethel, MA; Harrison, P; Sourij, H; Sun, Y; Tucker, L; Kennedy, I; White, S; Hill, L; Oulhaj, A; Coleman, RL; Holman, RR.
Randomized controlled trial comparing impact on platelet reactivity of twice-daily with once-daily aspirin in people with Type 2 diabetes.
Diabet Med. 2016; 33(2):224-230 Doi: 10.1111/dme.12828
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Sourij Harald
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Abstract:
Reduced aspirin efficacy has been demonstrated in people with Type 2 diabetes. Because increased platelet reactivity and/or turnover are postulated mechanisms, we examined whether higher and/or more frequent aspirin dosing might reduce platelet reactivity more effectively. Participants with Type 2 diabetes (n = 24) but without known cardiovascular disease were randomized in a three-way crossover design to 2-week treatment periods with aspirin 100 mg once daily, 200 mg once daily or 100 mg twice daily. The primary outcome was platelet reactivity, assessed using the VerifyNow(™) ASA method. Relationships between platelet reactivity and aspirin dosing were examined using generalized linear mixed models with random subject effects. Platelet reactivity decreased from baseline with all doses of aspirin. Modelled platelet reactivity was more effectively reduced with aspirin 100 mg twice daily vs. 100 mg once daily, but not vs. 200 mg once daily. Aspirin 200 mg once daily did not differ from 100 mg once daily. Aspirin 100 mg twice daily was also more effective than once daily as measured by collagen/epinephrine-stimulated platelet aggregation and urinary thromboxane levels, with a similar trend measured by serum thromboxane levels. No episodes of bleeding occurred. In Type 2 diabetes, aspirin 100 mg twice daily reduced platelet reactivity more effectively than 100 mg once daily, and numerically more than 200 mg once daily. Clinical outcome trials evaluating primary cardiovascular disease prevention with aspirin in Type 2 diabetes may need to consider using a more frequent dosing schedule. © 2015 The Authors. Diabetic Medicine © 2015 Diabetes UK.
Find related publications in this database (using NLM MeSH Indexing)
Adult -
Aspirin - administration & dosage
Aspirin - adverse effects
Aspirin - therapeutic use
Cardiovascular Diseases - complications
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - prevention & control
Cross-Over Studies -
Cyclooxygenase Inhibitors - administration & dosage
Cyclooxygenase Inhibitors - adverse effects
Cyclooxygenase Inhibitors - therapeutic use
Diabetes Mellitus, Type 2 - blood
Diabetes Mellitus, Type 2 - complications
Diabetic Angiopathies - epidemiology
Diabetic Angiopathies - prevention & control
Diabetic Cardiomyopathies - epidemiology
Diabetic Cardiomyopathies - prevention & control
Dose-Response Relationship, Drug -
Double-Blind Method -
Drug Administration Schedule -
Drug Resistance -
England - epidemiology
Female -
Hemorrhage - chemically induced
Hemorrhage - complications
Hemorrhage - epidemiology
Humans -
Male -
Middle Aged -
Platelet Activation - drug effects
Platelet Aggregation Inhibitors - administration & dosage
Platelet Aggregation Inhibitors - adverse effects
Platelet Aggregation Inhibitors - therapeutic use
Risk -
Risk Assessment -

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