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Platelet reactivity and antiplatelet management in diabetic patients with coronary artery disease

P Claudio, N Annunziata, S Mega, R Melfi & DS Germano

Diabetes mellitus is characterized by enhanced platelet reactivity and impaired response to antiplatelet therapy, with a higher percentage of low responders and an increased risk of thrombotic events following an acute coronary syndrome and/or percutaneous coronary intervention. This evidence was utilized to investigate the effectiveness and safety of higher doses of clopidogrel as well as the use of newer and more potent antiplatelet drugs, such as prasugrel and ticagrelor, in this highrisk subset of patients. The aim of this paper is to systematically report the latest evidence on the prognostic role of diabetes mellitus on responsiveness to antiplatelet treatments and to discuss the most effective therapeutic strategy to be used in such patients.