Tratamiento antitrombótico en diabéticos con síndrome coronario agudo

Diabetic patients with acute coronary syndrome exhibit increased platelet reactivity and are at a greater risk of experiencing a cardiovascular event over both the short and long term than nondiabetics with the syndrome. Whereas aspirin appears to function similarly in diabetics with acute coronary syndrome as in nondiabetics, clopidogrel has less of an inhibitory effect on platelets in diabetic patients. The use of powerful antiplatelet agents, such as glycoprotein IIb/IIIa inhibitors, during the acute phase has been shown to be particularly effective in diabetics with the syndrome. In addition, dual antiplatelet therapy with aspirin and prasugrel has demonstrated greater benefits in diabetics than aspirin plus clopidogrel. Meanwhile, the development of alternative antiplatelet agents with novel platelet targets will help to counteract some of the numerous factors responsible for the platelet hyperreactivity seen in diabetic patients with acute coronary syndrome.