Background:
Diabetes mellitus (DM) is on the rise globally. Its prevalence has nearly doubled
during the last two decades and it is estimated to affect 8.8% of the global population.
Cardiovascular disease (CVD) is the leading cause of death in diabetic population and despite
modern anti-inflammatory and cardioprotective therapeutic strategies diabetic patients have at
least a twice fold risk of cardiovascular events. Prothrombotic state in DM is associated with
multiple determinants such as platelet alterations, oxidative stress, endothelial changes,
circulating mediators. Thus, proper antithrombotic strategies to reduce the risk of CVD in this
population is critical.
Methods:
This article reviews the current antiplatelet and anticoagulant
agents in the aspect of primary and secondary prevention of CVD in the diabetic population.
Results:
The use of aspirin may be considered only at high-risk patients in the absence of
contraindications. Cangrelor was not inferior to clopidogrel in preventing the composite outcome
of CV death, myocardial infraction and revascularization without increasing major bleeding.
Triple therapy in the subpopulation with DM significantly reduced the composite primary
outcome of CV death, myocardial infraction or repeat target lesion revascularization. That was
not the case for stent thrombosis, which was similar in both groups. Importantly, triple therapy
did not result in increased bleeding complications, which were similar in both groups. However,
cilostazol is linked to various adverse effects (e.g., headache, palpitations, and gastrointestinal
disturbances) that drive many patients to withdrawal.
Conclusion:
In conclusion, DM is a
rapidly growing disease that increases the risk of CVD, AF, and CV mortality. Proper
antithrombotic strategies to reduce CVD risk in DM is a necessity. Also, new antithrombotic
treatments and combination therapies may play a critical role to overcome antiplatelet resistance
in DM patients and reduce morbidity and mortality attributed to CVD.
health psychology report • volume 8(2), original article background Social support in women with breast cancer is associated with quality of life (QoL) and it appears to be vital for treating breast cancer and adaptation to disease. Social support seems to decrease quantitatively and over time while significant improvement in the patients' long-term emotional and physical function is observed. Therefore, the aim of this study was to investigate the differences in levels of social support and QoL in two independent groups of patients: women with breast cancer (i) during chemotherapy and (ii) two years after the chemotherapy. participants and procedure In this cross-sectional study 74 women with breast cancer "during chemotherapy" (n = 41) and "two years after chemotherapy" (n = 33) completed the Greek version of Multidimensional Scale of Perceived Social Support (MSPSS) and the Greek version of the Missoula-VITAS Quality of Life Index (MVQoLI-15) to measure social support and QoL respectively. All statistical analyses were performed with SPSS 25 with significance set at p < .05. results The group "two years after chemotherapy" reported better QoL than the "during chemotherapy" group. There was no difference in perceived social support between the two groups. The higher the patients' age, the lower the QoL for the "during chemotherapy" group and the higher the social support for the "two years after chemotherapy" group. conclusions QoL improves over time, emphasizing the ability of women to manage difficult situations. Social support remains important in both periods.
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