Platelets, diabetes and myocardial ischemia/reperfusion injury

Cardiovasc Diabetol. 2017 May 31;16(1):71. doi: 10.1186/s12933-017-0550-6.

Abstract

Mechanisms underlying the pathogenesis of ischemia/reperfusion injury are particularly complex, multifactorial and highly interconnected. A complex and entangled interaction is also emerging between platelet function, antiplatelet drugs, coronary diseases and ischemia/reperfusion injury, especially in diabetic conditions. Here we briefly summarize features of antiplatelet therapy in type 2 diabetes (T2DM). We also treat the influence of T2DM on ischemia/reperfusion injury and how anti-platelet therapies affect post-ischemic myocardial damage through pleiotropic properties not related to their anti-aggregating effects. miRNA-based signature associated with T2DM and its cardiovascular disease complications are also briefly considered. Influence of anti-platelet therapies and different effects of healthy and diabetic platelets on ischemia/reperfusion injury need to be further clarified in order to enhance patient benefits from antiplatelet therapy and revascularization. Here we provide insight on the difficulty to reduce the cardiovascular risk in diabetic patients and report novel information on the cardioprotective role of widely used anti-aggregant drugs.

Keywords: Antiplatelet therapy; Aspirin; Cardioprotection; Type 2 diabetes.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aspirin / adverse effects
  • Aspirin / therapeutic use*
  • Blood Platelets / drug effects*
  • Blood Platelets / metabolism
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / genetics
  • Drug Resistance
  • Humans
  • Ischemic Preconditioning, Myocardial* / adverse effects
  • MicroRNAs / genetics
  • MicroRNAs / metabolism
  • Myocardial Reperfusion Injury / blood
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / prevention & control*
  • Myocardium / metabolism*
  • Myocardium / pathology
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Risk Factors
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • MicroRNAs
  • Platelet Aggregation Inhibitors
  • Aspirin