Accelerated platelet activation in Asian Indians with diabetes and coronary artery disease - The Chennai Urban Population Study (CUPS-13)

Aim : To assess platelet activation in south Indian type 2 diabetic subjects with and without CAD. Methods : Four groups of subjects were studied; Group 1 comprised of non-diabetic subjects without coronary artery disease (CAD) (n = 30). Type 2 diabetic subjects without CAD formed Group 2 (n = 30); Group 3 comprised of type 2 diabetic subjects with CAD (n = 30) and Group 4 consisted of non- diabetic subjects with CAD (n=14). CAD was diagnosed based on coronary angiographic evidence of severe double or triple vessel disease. Platelet activation was tested after an overnight fast in blood obtained from a bleeding wound at 1 minute post-incision (wound-induced activation) as well as venous blood stimulated in vitro with collagen, using whole blood flow cytometry. In subjects with CAD, aspirin was withdrawn for 7 days and nitrates for 24 hours. Results : Collagen induced GP IIb/IIIa binding was significantly higher among diabetic subjects with (28.10 ± 19.89; p<0.05) and without CAD (21.02 ± 19.62; p<0.05) and non-diabetic subjects with CAD (23.89 ± 15.65; p<0.05) compared to non-diabetic subjects without CAD (11.69 ± 13.69). Regression analysis showed collagen induced GP IIb/IIIa binding to be significantly associated with CAD [odds ratio (OR): 1.029, p = 0.025] and diabetes (OR: 1.037, p = 0.007). Conclusion : Increased platelet activation is seen in urban south Indians with diabetes and CAD.