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ISSN (Online): 1873-4286

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Review Article

Antithrombotic Treatment in Diabetes Mellitus: A Review of the Literature about Antiplatelet and Anticoagulation Strategies Used for Diabetic Patients in Primary and Secondary Prevention

Author(s): Gerasimos Siasos*, Georgia Skotsimara, Evangelos Oikonomou, Marios Sagris, Mystakidi Vasiliki-Chara, Evanthia Bletsa, Panagiota Stampouloglou, Panagiotis Theofilis, Georgios Charalampous and Dimitris Tousoulis

Volume 26, Issue 23, 2020

Page: [2780 - 2788] Pages: 9

DOI: 10.2174/1381612826666200417145605

Price: $65

Abstract

Background: Diabetes mellitus (DM) is on the rise globally. Its prevalence has nearly doubled during the last two decades and it is estimated to affect 8.8% of the global population. Cardiovascular disease (CVD) is the leading cause of death in the diabetic population and despite modern anti-inflammatory and cardioprotective therapeutic strategies, diabetic patients have at least a twice fold risk of cardiovascular events. The prothrombotic state in DM is associated with multiple determinants such as platelet alterations, oxidative stress, endothelial changes, circulating mediators. Thus, proper antithrombotic strategies to reduce the risk of CVD in this population are critical.

Methods: This article reviews the current antiplatelet and anticoagulant agents in the aspect of primary and secondary prevention of CVD in the diabetic population.

Results: The use of aspirin may be considered only at high-risk patients in the absence of contraindications. Cangrelor was not inferior to clopidogrel in preventing the composite outcome of CV death, myocardial infarction and revascularization without increasing major bleeding. Triple therapy in the subpopulation with DM significantly reduced the composite primary outcome of CV death, myocardial infarction or repeat target lesion revascularization. That was not the case for stent thrombosis, which was similar in both groups. Importantly, triple therapy did not result in increased bleeding complications, which were similar in both groups. However, cilostazol is linked to various adverse effects (e.g., headache, palpitations, and gastrointestinal disturbances) that drive many patients to withdrawal.

Conclusion: In conclusion, DM is a rapidly growing disease that increases the risk of CVD, AF, and CV mortality. Proper antithrombotic strategies to reduce CVD risk in DM are a necessity. Moreover, new antithrombotic treatments and combination therapies may play a critical role to overcome antiplatelet resistance in DM patients and reduce morbidity and mortality attributed to CVD.

Keywords: Diabetes mellitus, cardiovascular disease, antiplatelets, anticoagulation, clopidogrel, myocardial infarction.

« Previous Next »
[1]
International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation. 2017. Available at http://www.diabetesatlas.org
[2]
Haffner SM, Lehto S, Rönnemaa T, Pyörälä K, Laakso M. Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339(4): 229-34.
[http://dx.doi.org/10.1056/NEJM199807233390404] [PMID: 9673301]
[3]
Harding JL, Pavkov ME, Magliano DJ, Shaw JE, Gregg EW. Global trends in diabetes complications: a review of current evidence. Diabetologia 2019; 62(1): 3-16.
[http://dx.doi.org/10.1007/s00125-018-4711-2] [PMID: 30171279]
[4]
Rawshani A, Rawshani A, Franzén S, et al. Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes. N Engl J Med 2017; 376(15): 1407-18.
[http://dx.doi.org/10.1056/NEJMoa1608664] [PMID: 28402770]
[5]
Guthikonda S, Lev EI, Patel R, et al. Reticulated platelets and uninhibited COX-1 and COX-2 decrease the antiplatelet effects of aspirin. J Thromb Haemost 2007; 5(3): 490-6.
[http://dx.doi.org/10.1111/j.1538-7836.2007.02387.x] [PMID: 17319904]
[6]
Rocca B, Secchiero P, Ciabattoni G, et al. Cyclooxygenase-2 expression is induced during human megakaryopoiesis and characterizes newly formed platelets. Proc Natl Acad Sci USA 2002; 99(11): 7634-9.
[http://dx.doi.org/10.1073/pnas.112202999] [PMID: 12032335]
[7]
Lev EI. Immature Platelets: Clinical Relevance and Research Perspectives. Circulation 2016; 134(14): 987-8.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.022538] [PMID: 27698048]
[8]
Tousoulis D, Oikonomou E, Siasos G, Stefanadis C. Diabetes Mellitus and Heart Failure. Eur Cardiol 2014; 9(1): 37-42.
[http://dx.doi.org/10.15420/ecr.2014.9.1.37] [PMID: 30310483]
[9]
Yamagishi S, Matsui T, Takenaka K, Nakamura K, Takeuchi M, Inoue H. Pigment epithelium-derived factor (PEDF) prevents platelet activation and aggregation in diabetic rats by blocking deleterious effects of advanced glycation end products (AGEs). Diabetes Metab Res Rev 2009; 25(3): 266-71.
[http://dx.doi.org/10.1002/dmrr.906] [PMID: 19165765]
[10]
Rubenstein DA, Maria Z, Yin W. Combined incubation of platelets and endothelial cells with glycated albumin: Altered thrombogenic and inflammatory responses. Diab Vasc Dis Res 2014; 11(4): 235-42.
[http://dx.doi.org/10.1177/1479164114531298] [PMID: 24821752]
[11]
Rubenstein DA, Morton BE, Yin W. The combined effects of sidestream smoke extracts and glycated serum albumin on endothelial cells and platelets. Cardiovasc Diabetol 2010; 9: 28.
[http://dx.doi.org/10.1186/1475-2840-9-28] [PMID: 20604957]
[12]
Soro-Paavonen A, Zhang WZ, Venardos K, et al. Advanced glycation end-products induce vascular dysfunction via resistance to nitric oxide and suppression of endothelial nitric oxide synthase. J Hypertens 2010; 28(4): 780-8.
[http://dx.doi.org/10.1097/HJH.0b013e328335043e] [PMID: 20186099]
[13]
ETDRS Investigators. Aspirin effects on mortality and morbidity in patients with diabetes mellitus. Early Treatment Diabetic Retinopathy Study report 14. JAMA 1992; 268(10): 1292-300.
[http://dx.doi.org/10.1001/jama.1992.03490100090033] [PMID: 1507375]
[14]
Belch J, MacCuish A, Campbell I, et al. Prevention of Progression of Arterial Disease and Diabetes Study Group; Diabetes Registry Group; Royal College of Physicians Edinburgh.. The prevention of progression of arterial disease and diabetes (POPADAD) trial: factorial randomised placebo controlled trial of aspirin and antioxidants in patients with diabetes and asymptomatic peripheral arterial disease. BMJ 2008; 337: a1840.
[http://dx.doi.org/10.1136/bmj.a1840] [PMID: 18927173]
[15]
Diehm C, Lange S, Darius H, et al. Association of low ankle brachial index with high mortality in primary care. Eur Heart J 2006; 27(14): 1743-9.
[http://dx.doi.org/10.1093/eurheartj/ehl092] [PMID: 16782720]
[16]
Ogawa H. [Series, clinical study from Japan and its reflections; Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) Trial]. Nippon Naika Gakkai Zasshi 2011; 100(1): 218-23.
[http://dx.doi.org/10.2169/naika.100.218] [PMID: 21387659]
[17]
Saito Y, Okada S, Ogawa H, et al. JPAD Trial Investigators. Low-Dose Aspirin for Primary Prevention of Cardiovascular Events in Patients With Type 2 Diabetes Mellitus: 10-Year Follow-Up of a Randomized Controlled Trial. Circulation 2017; 135(7): 659-70.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.025760] [PMID: 27881565]
[18]
Bowman L, Mafham M, Wallendszus K, et al. ASCEND Study Collaborative Group. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N Engl J Med 2018; 379(16): 1529-39.
[http://dx.doi.org/10.1056/NEJMoa1804988] [PMID: 30146931]
[19]
Lars Rydén, Peter J Grant, Stefan D Anker. etalThe Task Force on diabetes, p.-d., and cardiovascular diseases of the European Society of Cardiology (ESC) and developed in collaboration with the European Association for the Study of Diabetes (EASD), ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD 2019. Eur Heart J 2013; 34(39): 3035-87.
[20]
Committee CS. CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996; 348(9038): 1329-39.
[http://dx.doi.org/10.1016/S0140-6736(96)09457-3] [PMID: 8918275]
[21]
Bhatt DL, Marso SP, Hirsch AT, Ringleb PA, Hacke W, Topol EJ. Amplified benefit of clopidogrel versus aspirin in patients with diabetes mellitus. Am J Cardiol 2002; 90(6): 625-8.
[http://dx.doi.org/10.1016/S0002-9149(02)02567-5] [PMID: 12231089]
[22]
Bhatt DL, Fox KA, Hacke W, et al. CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354(16): 1706-17.
[http://dx.doi.org/10.1056/NEJMoa060989] [PMID: 16531616]
[23]
Bhatt DL, Flather MD, Hacke W, et al. CHARISMA Investigators. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. J Am Coll Cardiol 2007; 49(19): 1982-8.
[http://dx.doi.org/10.1016/j.jacc.2007.03.025] [PMID: 17498584]
[24]
Mauri L, Kereiakes DJ, Yeh RW, et al. DAPT Study Investigators. Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents. N Engl J Med 2014; 371(23): 2155-66.
[http://dx.doi.org/10.1056/NEJMoa1409312] [PMID: 25399658]
[25]
Meredith IT, Tanguay JF, Kereiakes DJ, et al. DAPT Study Investigators. Diabetes Mellitus and Prevention of Late Myocardial Infarction After Coronary Stenting in the Randomized Dual Antiplatelet Therapy Study. Circulation 2016; 133(18): 1772-82.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.115.016783] [PMID: 26994121]
[26]
Yeh RW, Secemsky EA, Kereiakes DJ, et al. DAPT Study Investigators. Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention. JAMA 2016; 315(16): 1735-49.
[http://dx.doi.org/10.1001/jama.2016.3775] [PMID: 27022822]
[27]
Levine GN, Bates ER, Bittl JA, et al. 2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol 2016; 68(10): 1082-115.
[http://dx.doi.org/10.1016/j.jacc.2016.03.513] [PMID: 27036918]
[28]
Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2018; 39(3): 213-60.
[http://dx.doi.org/10.1093/eurheartj/ehx419] [PMID: 28886622]
[29]
Bonaca MP, Bhatt DL, Cohen M, et al. PEGASUS-TIMI 54 Steering Committee and Investigators. Long-term use of ticagrelor in patients with prior myocardial infarction. N Engl J Med 2015; 372(19): 1791-800.
[http://dx.doi.org/10.1056/NEJMoa1500857] [PMID: 25773268]
[30]
Bhatt DL, Bonaca MP, Bansilal S, et al. Reduction in Ischemic Events With Ticagrelor in Diabetic Patients With Prior Myocardial Infarction in PEGASUS-TIMI 54. J Am Coll Cardiol 2016; 67(23): 2732-40.
[http://dx.doi.org/10.1016/j.jacc.2016.03.529] [PMID: 27046160]
[31]
Steg PG, Bhatt DL, Simon T, et al. THEMIS Steering Committee and Investigators. Ticagrelor in Patients with Stable Coronary Disease and Diabetes. N Engl J Med 2019; 381(14): 1309-20.
[http://dx.doi.org/10.1056/NEJMoa1908077] [PMID: 31475798]
[32]
Bhatt DL, Steg PG, Mehta SR, et al. THEMIS Steering Committee and Investigators. Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial. Lancet 2019; 394(10204): 1169-80.
[http://dx.doi.org/10.1016/S0140-6736(19)31887-2] [PMID: 31484629]
[33]
Eikelboom JW, Connolly SJ, Bosch J, et al. COMPASS Investigators. Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease. N Engl J Med 2017; 377(14): 1319-30.
[http://dx.doi.org/10.1056/NEJMoa1709118] [PMID: 28844192]
[34]
Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK. Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345(7): 494-502.
[http://dx.doi.org/10.1056/NEJMoa010746] [PMID: 11519503]
[35]
Mehta SR, Yusuf S, Peters RJ, et al. Clopidogrel in Unstable angina to prevent Recurrent Events trial (CURE) Investigators. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358(9281): 527-33.
[http://dx.doi.org/10.1016/S0140-6736(01)05701-4] [PMID: 11520521]
[36]
Steinhubl SR, Berger PB, Mann JT III, et al. CREDO Investigators. Clopidogrel for the Reduction of Events During Observation. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA 2002; 288(19): 2411-20.
[http://dx.doi.org/10.1001/jama.288.19.2411] [PMID: 12435254]
[37]
Wiviott SD, Antman EM, Gibson CM, et al. TRITON-TIMI 38 Investigators. Evaluation of prasugrel compared with clopidogrel in patients with acute coronary syndromes: design and rationale for the TRial to assess Improvement in Therapeutic Outcomes by optimizing platelet InhibitioN with prasugrel Thrombolysis In Myocardial Infarction 38 (TRITON-TIMI 38). Am Heart J 2006; 152(4): 627-35.
[http://dx.doi.org/10.1016/j.ahj.2006.04.012] [PMID: 16996826]
[38]
Wallentin L, Becker RC, Budaj A, et al. PLATO Investigators. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009; 361(11): 1045-57.
[http://dx.doi.org/10.1056/NEJMoa0904327] [PMID: 19717846]
[39]
Investigators C-O. Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. N Engl J Med 2010; 363(10): 930-42.
[40]
Mehta SR, Tanguay JF, Eikelboom JW, et al. CURRENT-OASIS 7 trial investigators. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet 2010; 376(9748): 1233-43.
[http://dx.doi.org/10.1016/S0140-6736(10)61088-4] [PMID: 20817281]
[41]
Wiviott SD, Braunwald E, Angiolillo DJ, et al. TRITON-TIMI 38 Investigators. Greater clinical benefit of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel-Thrombolysis in Myocardial Infarction 38. Circulation 2008; 118(16): 1626-36.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.108.791061] [PMID: 18757948]
[42]
Harrington RA, Stone GW, McNulty S, et al. Platelet inhibition with cangrelor in patients undergoing PCI. N Engl J Med 2009; 361(24): 2318-29.
[http://dx.doi.org/10.1056/NEJMoa0908628] [PMID: 19915221]
[43]
Bhatt DL, Lincoff AM, Gibson CM, et al. CHAMPION PLATFORM Investigators. Intravenous platelet blockade with cangrelor during PCI. N Engl J Med 2009; 361(24): 2330-41.
[http://dx.doi.org/10.1056/NEJMoa0908629] [PMID: 19915222]
[44]
Bhatt DL, Stone GW, Mahaffey KW, et al. CHAMPION PHOENIX Investigators. Effect of platelet inhibition with cangrelor during PCI on ischemic events. N Engl J Med 2013; 368(14): 1303-13.
[http://dx.doi.org/10.1056/NEJMoa1300815] [PMID: 23473369]
[45]
Lu H, Guan W, Zhou Y, Tang Z, Bao H. Cangrelor or Clopidogrel in Patients with Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials. Diabetes Ther 2019; 10(3): 937-50.
[http://dx.doi.org/10.1007/s13300-019-0593-7] [PMID: 30905057]
[46]
Mega JL, Braunwald E, Wiviott SD, et al. ATLAS ACS 2–TIMI 51 Investigators. Rivaroxaban in patients with a recent acute coronary syndrome. N Engl J Med 2012; 366(1): 9-19.
[http://dx.doi.org/10.1056/NEJMoa1112277] [PMID: 22077192]
[47]
Neumann FJ, et al. [2018 ESC/EACTS Guidelines on myocardial revascularization. The Task Force on myocardial revascularization of the European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS)].. G Ital Cardiol (Rome) 2019; 20(7): 1-61.
[PMID: 30638210]
[48]
Mehilli J, Kastrati A, Schühlen H, et al. Intracoronary Stenting and Antithrombotic Regimen: Is Abciximab a Superior Way to Eliminate Elevated Thrombotic Risk in Diabetics (ISAR-SWEET) Study Investigators. Randomized clinical trial of abciximab in diabetic patients undergoing elective percutaneous coronary interventions after treatment with a high loading dose of clopidogrel. Circulation 2004; 110(24): 3627-35.
[http://dx.doi.org/10.1161/01.CIR.0000148956.93631.4D] [PMID: 15531766]
[49]
Kastrati A, Mehilli J, Neumann FJ, et al. Intracoronary Stenting and Antithrombotic: Regimen Rapid Early Action for Coronary Treatment 2 (ISAR-REACT 2) Trial Investigators. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. JAMA 2006; 295(13): 1531-8.
[http://dx.doi.org/10.1001/jama.295.13.joc60034] [PMID: 16533938]
[50]
De Luca G, Navarese E, Marino P. Risk profile and benefits from Gp IIb-IIIa inhibitors among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-regression analysis of randomized trials. Eur Heart J 2009; 30(22): 2705-13.
[http://dx.doi.org/10.1093/eurheartj/ehp118] [PMID: 19875386]
[51]
Lee SW, Park SW, Kim YH, et al. Drug-eluting stenting followed by cilostazol treatment reduces late restenosis in patients with diabetes mellitus the DECLARE-DIABETES Trial (A Randomized Comparison of Triple Antiplatelet Therapy with Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Diabetic Patients). J Am Coll Cardiol 2008; 51(12): 1181-7.
[http://dx.doi.org/10.1016/j.jacc.2007.11.049] [PMID: 18355656]
[52]
Bundhun PK, Qin T, Chen MH. Comparing the effectiveness and safety between triple antiplatelet therapy and dual antiplatelet therapy in type 2 diabetes mellitus patients after coronary stents implantation: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovasc Disord 2015; 15: 118.
[http://dx.doi.org/10.1186/s12872-015-0114-1] [PMID: 26450578]
[53]
Gurbel PA, Jeong YH, Tantry US. Vorapaxar: a novel protease-activated receptor-1 inhibitor. Expert Opin Investig Drugs 2011; 20(10): 1445-53.
[http://dx.doi.org/10.1517/13543784.2011.606809] [PMID: 21819272]
[54]
Tricoci P, Huang Z, Held C, et al. TRACER Investigators. Thrombin-receptor antagonist vorapaxar in acute coronary syndromes. N Engl J Med 2012; 366(1): 20-33.
[http://dx.doi.org/10.1056/NEJMoa1109719] [PMID: 22077816]
[55]
Morrow DA, Braunwald E, Bonaca MP, et al. TRA 2P–TIMI 50 Steering Committee and Investigators. Vorapaxar in the secondary prevention of atherothrombotic events. N Engl J Med 2012; 366(15): 1404-13.
[http://dx.doi.org/10.1056/NEJMoa1200933] [PMID: 22443427]
[56]
Cavender MA, Scirica BM, Bonaca MP, et al. Vorapaxar in patients with diabetes mellitus and previous myocardial infarction: findings from the thrombin receptor antagonist in secondary prevention of atherothrombotic ischemic events-TIMI 50 trial. Circulation 2015; 131(12): 1047-53.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.114.013774] [PMID: 25681464]
[57]
Stone GW, Bertrand M, Colombo A, et al. Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial: study design and rationale. Am Heart J 2004; 148(5): 764-75.
[http://dx.doi.org/10.1016/j.ahj.2004.04.036] [PMID: 15523305]
[58]
Feit F, Manoukian SV, Ebrahimi R, et al. Safety and efficacy of bivalirudin monotherapy in patients with diabetes mellitus and acute coronary syndromes: a report from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial. J Am Coll Cardiol 2008; 51(17): 1645-52.
[http://dx.doi.org/10.1016/j.jacc.2007.11.081] [PMID: 18436116]
[59]
Pallisgaard JL, Schjerning AM, Lindhardt TB, et al. Risk of atrial fibrillation in diabetes mellitus: A nationwide cohort study. Eur J Prev Cardiol 2016; 23(6): 621-7.
[http://dx.doi.org/10.1177/2047487315599892] [PMID: 26254188]
[60]
Mozaffarian D, Benjamin EJ, Go AS, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee Heart disease and stroke statistics--2015 update: a report from the American Heart Association.. Circulation 2015; 131(4): e29-e322.
[http://dx.doi.org/10.1161/CIR.0000000000000152] [PMID: 25520374]
[61]
Du X, Ninomiya T, de Galan B, et al. ADVANCE Collaborative Group. Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results of the ADVANCE study. Eur Heart J 2009; 30(9): 1128-35.
[http://dx.doi.org/10.1093/eurheartj/ehp055] [PMID: 19282274]
[62]
Lip GY, Lane DA. Stroke prevention in atrial fibrillation: a systematic review. JAMA 2015; 313(19): 1950-62.
[http://dx.doi.org/10.1001/jama.2015.4369] [PMID: 25988464]
[63]
Chao TF, Liu CJ, Wang KL, et al. Should atrial fibrillation patients with 1 additional risk factor of the CHA2DS2-VASc score (beyond sex) receive oral anticoagulation? J Am Coll Cardiol 2015; 65(7): 635-42.
[http://dx.doi.org/10.1016/j.jacc.2014.11.046] [PMID: 25677422]
[64]
Connolly SJ, Ezekowitz MD, Yusuf S, et al. RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med 2009; 361(12): 1139-51.
[http://dx.doi.org/10.1056/NEJMoa0905561] [PMID: 19717844]
[65]
Patel MR, Mahaffey KW, Garg J, et al. ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011; 365(10): 883-91.
[http://dx.doi.org/10.1056/NEJMoa1009638] [PMID: 21830957]
[66]
Giugliano RP, Ruff CT, Braunwald E, et al. ENGAGE AF-TIMI 48 Investigators. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2013; 369(22): 2093-104.
[http://dx.doi.org/10.1056/NEJMoa1310907] [PMID: 24251359]
[67]
Granger CB, Alexander JH, McMurray JJ, et al. ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med 2011; 365(11): 981-92.
[http://dx.doi.org/10.1056/NEJMoa1107039] [PMID: 21870978]
[68]
Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014; 383(9921): 955-62.
[http://dx.doi.org/10.1016/S0140-6736(13)62343-0] [PMID: 24315724]
[69]
DiChiara J, Bliden KP, Tantry US, et al. The effect of aspirin dosing on platelet function in diabetic and nondiabetic patients: an analysis from the aspirin-induced platelet effect (ASPECT) study. Diabetes 2007; 56(12): 3014-9.
[http://dx.doi.org/10.2337/db07-0707] [PMID: 17848625]
[70]
Scheen AJ, Legrand D. Aspirin and clopidogrel resistance in patients with diabetes mellitus. Eur Heart J 2006; 27(23): 2900.
[http://dx.doi.org/10.1093/eurheartj/ehl295] [PMID: 17015405]

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