Prevention of atherothrombotic events in patients with diabetes mellitus: from antithrombotic therapies to new-generation glucose-lowering drugs

Felicita Andreotti, Mattia Galli, Giuseppe Patti, Ilaria Cavallari, Paolo Calabrò, Plinio Cirillo, Gentian Denas, Enrica Golia, Ernesto Maddaloni, Rossella Marcucci, Vito Maurizio Parato, Vittorio Pengo, Domenico Prisco, Elisabetta Ricottini, Giulia Renda, Francesca Santilli, Paola Simeone, Raffaele De Caterina

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Diabetes mellitus is an important risk factor for a first cardiovascular event and for worse outcomes after a cardiovascular event has occurred. This situation might be caused, at least in part, by the prothrombotic status observed in patients with diabetes. Therefore, contemporary antithrombotic strategies, including more potent agents or drug combinations, might provide greater clinical benefit in patients with diabetes than in those without diabetes. In this Consensus Statement, our Working Group explores the mechanisms of platelet and coagulation activity, the current debate on antiplatelet therapy in primary cardiovascular disease prevention, and the benefit of various antithrombotic approaches in secondary prevention of cardiovascular disease in patients with diabetes. While acknowledging that current data are often derived from underpowered, observational studies or subgroup analyses of larger trials, we propose antithrombotic strategies for patients with diabetes in various cardiovascular settings (primary prevention, stable coronary artery disease, acute coronary syndromes, ischaemic stroke and transient ischaemic attack, peripheral artery disease, atrial fibrillation, and venous thromboembolism). Finally, we summarize the improvements in cardiovascular outcomes observed with the latest glucose-lowering drugs, and on the basis of the available evidence, we expand and integrate current guideline recommendations on antithrombotic strategies in patients with diabetes for both primary and secondary prevention of cardiovascular disease.
Original languageEnglish
Pages (from-to)113-130
Number of pages18
JournalNATURE REVIEWS. CARDIOLOGY
Volume16
DOIs
Publication statusPublished - 2019

Keywords

  • blood coagulation

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