Antithrombotische Therapie

Platelet function is one of the main components in the development of atherosclerosis and atherothrombotic clinical events. Patients with diabetes mellitus in particular exhibit increased platelet activity and reduced inhibition in response to platelet inhibitors. The general administration of aspirin in all patients with diabetes mellitus type 2 is recommended by some scientific societies. In clinically stable patients, secondary prevention with clopidogrel is superior to the use of aspirin. In patients with diabetes mellitus, the relative risk reduction with clopidogrel is four times higher than the risk reduction in non-diabetics. Dual platelet inhibitor therapy has no clinical advantages in these stable patients. In contrast, dual antiplatelet therapy is significantly superior to monotherapy with aspirin in patients with acute coronary syndrome. Although the relative risk reduction in patients with diabetes mellitus is comparable to the rate in non-diabetics, the absolute number of events prevented in these patients is significantly higher due to the higher event rate. The results presented suggest that the clinical outcome in patients with diabetes mellitus is mainly determined by the degree of platelet activation and its effective inhibition by platelet inhibitors.