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The continuous challenge of antithrombotic strategies in diabetes: focus on direct oral anticoagulants
AbstractDirect oral anticoagulants (DOACs) include dabigatran, which inhibits thrombin, and apixaban, edoxaban, and rivaroxaban, which inhibit factor Xa. They have been extensively studied in large trials involving patients affected by the most common cardiovascular diseases. As the presence of diabetes leads to peculiar changes in primary and secondary hemostasis, in this review we highlight the current evidence regarding DOAC use in diabetic patients included in the majority of recently conducted studies. Overall, in trials involving patients with atrial fibrillation, data seem to confirm at least a similar efficacy and ...
Source: Acta Diabetologica - September 23, 2019 Category: Endocrinology Source Type: research

Does type 2 diabetes affect the on-treatment levels of direct oral anticoagulants in patients with atrial fibrillation?
Type 2 diabetes (T2D) is connected with higher risk of stroke and systemic embolism in patients with atrial fibrillation (AF). Therefore, T2D patients with AF more often require long-term anticoagulation. Recently, direct oral anticoagulants (DOACs) - direct thrombin inhibitor dabigatran [1], direct factor Xa inhibitors rivaroxaban [2] and apixaban [3] - had been introduced for prevention of stroke and systemic embolism in patients with non-valvular AF (NV-AF). These agents generally offer some advantages, such as consistent and predictable anticoagulation, oral administration with good patient compliance and a good safety profile.
Source: Diabetes Research and Clinical Practice - November 23, 2017 Category: Endocrinology Authors: Matej Samo š, Tomáš Bolek, Lucia Stančiaková, Ingrid Škorňová, Jela Ivanková, František Kovář, Peter Galajda, Peter Kubisz, Ján Staško, Marián Mokáň Source Type: research

Plasma lipids affect dabigatran etexilate anticoagulation in rats with unbalanced diabetes mellitus
ConclusionsThis study indicates a significantly more intense DE‐induced anticoagulation in diabetic rats that does not seem to be solely related to altered kidney function, and demonstrates that plasma cholesterol can significantly affect DE‐anticoagulation in this setting. These results could explain the similar benefits of DE on stroke prevention in patients with and without DM, despite the significantly higher intrinsic thrombotic risk of the former, as well as the lack of benefit of reducing major bleeding in diabetics.
Source: Journal of Diabetes - July 1, 2017 Category: Endocrinology Authors: Alina Scridon, Marcel Perian, Alina M ărginean, Adina Huțanu, Doina Gherțescu, Adriana Vântu, Paul Ciprian Fișcă, Philippe Chevalier, Răzvan Constantin Șerban, Dan Dobreanu Tags: Original Article Source Type: research