Effects of Ramadan fasting on platelet reactivity in diabetic patients treated with clopidogrel

Thrombosis Journal

Research

F. Added¹  Z. Dridi²  S. Nouira³  W. Bouida³  H. Baccouche³  R. Boukef⁴  I. Khochtali⁵  M. Hassine⁶  I. Hellara⁶  M. Sassi⁷  R. Razgallah⁸  T. Chakroun⁹ 

[1] Cardiology Department, Abderrahman Mami University Hospital, 1080, Ariana, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Cardiology Department, Fattouma Bourguiba University Hospital, 5000, Monastir, Tunisia;Emergency Department, Fattouma Bourguiba University Hospital, 5000, Monastir, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Emergency Department, Sahloul University Hospital, 4011, Sousse, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Endocrinology and Internal Medicine Department, Fattouma Bourguiba University Hospital, 5000, Monastir, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Hematology Department, Fattouma Bourguiba University Hospital, 5000, Monasitr, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Laboratory of Biology, Maternity and Neonatal Medicine Center, 5000, Monastir, Tunisia;Research Laboratory (LR12SP18), University of Monastir, 5000, Monastir, Tunisia;Medis Laboratories, 1053, Tunis, Tunisia;Regional Blood Transfusion Center, Farhat Hached University Hospital, 4004, Sousse, Tunisia;

关键词: Fasting;    Platelet aggregation inhibitors;    Diabetes mellitus;    Platelet activation;    Clopidogrel;   

DOI  :  10.1186/s12959-017-0138-0

 received in 2017-05-15, accepted in 2017-05-25,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe effects of Ramadan fasting (RF) on clopidogrel antiplatelet inhibition were not previously investigated. The present study evaluated the influence of RF on platelet reactivity in patients with high cardiovascular risk (CVR) in particular those with type 2 diabetes mellitus (DM).MethodsA total of 98 stable patients with ≥2 CVR factors were recruited. All patients observed RF and were taking clopidogrel at a maintenance dose of 75 mg. Clinical findings and serum lipids data were recorded before Ramadan (Pre-R), at the last week of Ramadan (R) and 4 weeks after the end of Ramadan (Post-R). During each patient visit, nutrients intakes were calculated and platelet reactivity assessment using Verify Now P2Y12 assay was performed.ResultsIn DM patients, the absolute PRU changes from baseline were +27 (p = 0.01) and +16 (p = 0.02) respectively at R and Post-R. In addition, there was a significant increase of glycemia and triglycerides levels with a significant decrease of high-density lipoprotein. In non DM patients there was no significant change in absolute PRU values and metabolic parameters. Clopidogrel resistance rate using 2 cut-off PRU values (235 and 208) did not change significantly in DM and non DM patients.ConclusionsRF significantly decreased platelet sensitivity to clopidogrel in DM patients during and after Ramadan. This effect is possibly related to an increase of glycemia and serum lipids levels induced by fasting.Trial registrationClinical Trials.gov NCT02720133. Registered 24 July 2014.Retrospectively registered.

【 授权许可】

CC BY   
© The Author(s). 2017