Platelet reactivity in diabetic patients subjected to acute exercise stress test

Cardiovasc Revasc Med. 2011 Jan-Feb;12(1):20-4. doi: 10.1016/j.carrev.2010.01.005. Epub 2010 Oct 20.

Abstract

Background: Previous studies have reported ambiguous results regarding the effect of acute exercise on platelet reactivity in healthy and cardiac patients.

Objectives: We aimed to assess platelet reactivity among diabetic patients before and immediately after an acute exercise stress test.

Methods: Patients (controls: mean age 53.1 ± 12.1 years; four males; body mass index 27.0 ± 5.7 kg/m(2); HbA(1c) 6.0 ± 1.1%, n = 8) and diabetic patients (52.9 ± 11.3; six males; body mass index 30.7 ± 2.2 kg/m(2); HbA(1c) 7.8 ± 1.7%, n = 8) referred for diagnostic nuclear exercise stress test were recruited. Blood samples obtained at rest and immediately post-exercise were stimulated with adenosine diphosphate (ADP), collagen and arachidonic acid. Expression of CD41 (pan-platelet marker) and CD62p (platelet stimulation marker) were measured by flow cytometry. Aspirin responsiveness was measured using VerifyNow.

Results: Although peak systolic blood pressure was significantly higher in the diabetics compared with nondiabetics (186.3 ± 25.4 vs. 157.1 ± 19.1, respectively, P = .028), peak exercise heart rate was similar (156.5 ± 8.3 vs. 155.5 ± 12.1 for diabetics and nondiabetics, respectively). No differences were observed between groups for aspirin resistance. Platelet stimulation with ADP exhibited significantly lower CD62p-positive cell population (%) in the diabetic patients both prior to and following the exercise stress test (P = .03). In addition, although not significant, platelet stimulation was higher post-exercise in the diabetic patients (6.3 ± 4.7% vs. 12.0 ± 5.6%, for pre- and post-exercise, respectively, P = .2) with no difference in controls (9.2 ± 5.5% vs. 8.9 ± 5.9%).

Conclusion: Platelet stimulation in diabetic patients is blunted and might be explained by the prolonged exposure of platelets to multiple diabetic risk factors.

MeSH terms

  • Adenosine Diphosphate
  • Adult
  • Aged
  • Arachidonic Acid
  • Aspirin / pharmacology
  • Biomarkers / blood
  • Blood Pressure
  • Case-Control Studies
  • Collagen
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / physiopathology
  • District of Columbia
  • Drug Resistance
  • Exercise Test*
  • Female
  • Flow Cytometry
  • Heart Rate
  • Humans
  • Integrin alpha2 / blood
  • Male
  • Middle Aged
  • P-Selectin / blood
  • Platelet Activation* / drug effects
  • Platelet Aggregation Inhibitors / pharmacology
  • Platelet Function Tests*
  • Time Factors

Substances

  • Biomarkers
  • ITGA2B protein, human
  • Integrin alpha2
  • P-Selectin
  • Platelet Aggregation Inhibitors
  • SELP protein, human
  • Arachidonic Acid
  • Adenosine Diphosphate
  • Collagen
  • Aspirin