The effect of type two diabetes mellitus on platelet aggregation in patients with a history of multifocal atherosclerosis and ischemic stroke
A. S. Zhigunova,
V. А. Sorokoumov,
T. V. Vavilova,
I. D. Bogatenkova,
E. А. Yakovleva,
E. V. Eragheva,
G. I. Shvartsman,
A. А. Korovyakova,
A. B. Belevitin https://doi.org/10.24884/1607-4181-2025-32-4-116-121
Abstract
The objective was to assess the impact of antiplatelet therapy using acetylsalicylic acid on platelet aggregation in patients with diabetes mellitus and a history of ischemic stroke.
Methods and materials. Two groups of patients (target and control) were selected, comprising 72 individuals who had experienced either a lacunar or an atherothrombotic subtype of ischemic stroke within the past two years, accompanied by multifocal atherosclerosis. The target group consisted of 38 patients with type 2 diabetes mellitus, managed through hypoglycemic therapy, while the control group included 34 patients without type 2 diabetes mellitus.
Results. The evaluation of aggregatometry results revealed that platelet hypoaggregation was significantly more prevalent in response to acetylsalicylic acid therapy in the group of patients without diabetes mellitus. In contrast, laboratory resistance to acetylsalicylic acid was notable predominant in the group of patients with diabetes mellitus. This resistance may indicate insufficient therapeutic efficacy in clinical practice, potentially leading to recurrent cardiovascular events.
Conclusion. It is advisable to incorporate platelet aggregation capacity assessment via impedance aggegatometry as part of secondary prevention strategies for ischemic stroke to evaluate the therapeutic effectiveness of the antiplatelet drugs. Additionally, identifying excessive platelet hypoaggregation may be crucial in patients with an elevated risk of bleeding.
About the Authors
A. S. Zhigunova
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Zhigunova Aliona S., Neurologist, Stroke Prevention Center
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
V. А. Sorokoumov
City Consultative and Diagnostic Center № 1; Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Sorokoumov Viktor А., Professor, Dr. of Sci. (Med.), Professor of the Department of Neurology
10, liter A, Sikeiros str., Saint Petersburg, 194354;
6-8, L’va Tolstogo str., Saint Petersburg, 197022
Competing Interests:
Authors declare no conflict of interest
T. V. Vavilova
City Consultative and Diagnostic Center № 1; Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Vavilova Tatiana V., Dr. of Sci. (Med.), Professor, Chief
Freelance Specialist in Clinical Laboratory Diagnostics, Head of the Department of Laboratory Medicine and Genetics
10, liter A, Sikeiros str., Saint Petersburg, 194354;
2, Akkuratova str., Saint Petersburg, 197341
Competing Interests:
Authors declare no conflict of interest
I. D. Bogatenkova
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Bogatenkova Iuliia D., Cand. of Sci. (Med.), Neurologist, Head of the Stroke Prevention Center
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
E. А. Yakovleva
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Yakovleva Elena А., Neurologist, Stroke Prevention Center
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
E. V. Eragheva
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Eragheva Elena V., Cand. of Sci. (Med.), Neurologist, Stroke Prevention Center
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
G. I. Shvartsman
North-Western State Medical University named after I. I. Mechnikov
Russian Federation
Competing Interests:
Russian Federation
Shvartsman Grigorii I., Professor, Dr. of Sci. (Med.), Professor of the Department of Neurology named after Academician S. N. Davidenkov, Member of the Association of Neurologists of Saint Petersburg and the Leningrad Region, Member of the North-Western Association for the Study of Pain, Member of the All-Russian Society of Neurologists
41, Kirochnaya str., Saint Petersburg , 191015
Competing Interests:
Authors declare no conflict of interest
A. А. Korovyakova
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Korovyakova Anna А., Doctor of the Clinical Laboratory
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
A. B. Belevitin
City Consultative and Diagnostic Center № 1
Russian Federation
Competing Interests:
Russian Federation
Belevitin Aleksandr B., Professor, Dr. of Sci. (Med.), Chief Physician
10, liter A, Sikeiros str., Saint Petersburg, 194354
Competing Interests:
Authors declare no conflict of interest
References
1. Avilova M. V., Kosmacheva E. D. Multifocal atherosclerosis: the problem of combined atherosclerotic lesion of arteries // Creative Cardiology. – 2013. – Vol. 7, № 1. – P. 5–13. (In Russ.).
2. Clinical Guidelines for Ischemic Stroke and Transient Ischemic Attack 2024. URL: https://congress-med.ru/assets/files/%D0%BE%D0%B1%D0%BD%D0%BE%D0%B2%D0%B0/1/2024-klinicheskierekomendaczii-mz-rf-po-insultu-i-tia.pdf (accessed: 18.02.25). (In Russ.).
3. Severina A., Shestakova M. Hemostasis system disorders in patients with diabetes mellitus // Diabetes mellitus. 2004;7(1):62–67. (In Russ.).
4. Schiattarella G. G., Carrizzo A., Ilardi F. et al. Rac1 Modulates Endothelial Function and Platelet Aggregation in Diabetes Mellitus // Journal of the American Heart Association. 2018; 7(8): e007322.
5. Gontschar I. A., Shishlo L. M., Ju T. Bаnchkouskaya. Impedance agregometriya of platelets and functional outcome of the sharp heart attack of the brain // Military Medicine. 2015;(2):23–25. (In Russ.).
6. Rodionova O. V, Sorokoumov V. A, Vavilova T. V. et al. Changes in impedance agregatometry in patients with a history of stroke receiving antiplatelet drugs // Arterial Hypertension. 2017;23(6):507–516. (In Russ.). https://doi.org/10.18705/1607-419X-2017-23-6-507-516.
Review
For citations:
Zhigunova A.S., Sorokoumov V.А., Vavilova T.V., Bogatenkova I.D., Yakovleva E.А., Eragheva E.V., Shvartsman G.I., Korovyakova A.А., Belevitin A.B. The effect of type two diabetes mellitus on platelet aggregation in patients with a history of multifocal atherosclerosis and ischemic stroke. The Scientific Notes of the Pavlov University. 2025;32(4):116-121. (In Russ.) https://doi.org/10.24884/1607-4181-2025-32-4-116-121
Views:
54
JATS XML
Email this article 