Rapid Change of Platelet Aggregability in Acute Hyperglycemia

Abstract

We examined the alteration of platelet aggregability in acute hyperglycemia during 75-gram oral glucose tolerance tests (OGTT). Twenty subjects underwent 75-gram OGTT and venous blood samples were obtained before (0 min), 60, 120 and 180 min postload. Platelet aggregability shown as the number of small platelet aggregates was measured with a novel laser-light scattering (LS) method. Platelet aggregability increased in parallel with both glucose and immunoreactive insulin (IRI) levels. The number of mean small aggregates at 60 min (12.30 ± 1.10 ϫ 10 4 ) was significantly higher than the one at 0 min (8.32 ± 0.88 ϫ 10 4 , p Ͻ0.001), 120 min (10.63 ± 0.98 ϫ 10 4 , p Ͻ0.05) and 180 min (8.28 ± 0.84 ϫ 10 4 , p Ͻ0.001) (mean ± SEM). Small aggregates correlated positively with plasma glucose levels at 60 min postload (r = 0.67, p = 0.001) while not with IRI. It might be important to suppress transient hyperglycemia for preventing the onset of acute coronary syndromes that could be closely related to platelet hyperaggregability.

Increased Plasma Levels of Thioredoxin in Patients with Glucose Intolerance

“…These findings may suggest that not only DM but also IGT is an important risk factor for CAD because oxidative stress in patients with IGT was as high as that in patients with DM. These findings are agreement with the previous reports that postprandial hyperglycemia is one of the risk factors for CAD through an increase in oxidative stress (6,15). Furthermore, it has been reported that hyperglycemia induces oxidative stress in an animal model and the level of thioredoxin is higher in patients with multiple coronary risk factors (16,17).…”

Acute Hyperglycemia an Independent Risk Factor for Contrast-Induced Nephropathy in Patients Undergoing Primary Percutaneous Coronary Intervention for STEMI

“…Several studies have demonstrated that acute hyperglycemia is a powerful predictor of mortality, larger infarct size and increased risk of cardiovascular complications in myocardial infarction patients regardless of the diabetic state [30][31][32][33][34][35]. For every 18-mg/ dL increase in glucose level, there is a 4% increase in mortality in nondiabetic patients presenting with myocardial infarction [36].…”

Admission Hyperglycemia Is an Independent Predictor of Acute Kidney Injury in Patients With Acute Myocardial Infarction

“…Multiple physiological studies have shown that hyperglycemia has a direct detrimental effect on ischemic myocardium through several mechanisms, including oxidative stress, inflammation, apoptosis, endothelial dysfunction, hypercoagulation, and platelet aggregation. 14- 16 Brief episodes of antecedent myocardial ischemia have protective effects against subsequent prolonged ischemia, termed 'ischemic preconditioning'. Such effects are also generated by brief intermittent ischemia after the ischemic event (postconditioning) and observed even in remote organs (remote conditioning).…”