High-Dose Aspirin Is Required to Influence Plasma Fibrin Network Structure in Patients With Type 1 Diabetes
- Sara Tehrani, MD1⇓,
- Aleksandra Antovic, MD, PHD1,
- Fariborz Mobarrez, BSC2,
- Koteiba Mageed, MD1,
- Per-Eric Lins, MD, PHD1,
- Ulf Adamson, MD, PHD1,
- Håkan N. Wallén, MD, PHD2 and
- Gun Jörneskog, MD, PHD1
- 1Division of Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- 2Division of Cardiology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
- Corresponding author: Sara Tehrani, .
OBJECTIVE Patients with type 1 diabetes form a less permeable fibrin network, which could contribute to their increased risk of cardiovascular disease (CVD). Low-dose aspirin treatment is the standard in the management of CVD; however, the effect seems reduced in patients with diabetes. We investigated the effects of low- and high-dose aspirin treatment on fibrin network formation in patients with type 1 diabetes (primary aim) and the possible interaction between the treatment effects of aspirin on fibrin network permeability and glycemic control in these patients (secondary aim).
RESEARCH DESIGN AND METHODS Forty-eight patients (24 subjects with good [HbA1c <7.4%] and 24 subjects with poor [HbA1c >8.4%] glycemic control) were randomly assigned to treatment with 75 or 320 mg/day aspirin during 4 weeks in a crossover fashion. A 4-week washout period separated the treatment periods. The plasma fibrin network was assessed by determination of the permeability coefficient (Ks).
RESULTS Treatment with 75 mg aspirin did not influence fibrin network permeability (Ks). However, Ks increased significantly during treatment with 320 mg aspirin (P = 0.004), and a significant treatment effect was seen compared with treatment with 75 mg aspirin (P = 0.009). The increase in Ks during high-dose aspirin treatment was significant in patients with poor glycemic control (P = 0.02), whereas Ks only tended to increase in patients with good glycemic control (P = 0.06).
CONCLUSIONS A high dose of aspirin is required to influence fibrin network permeability in patients with type 1 diabetes. The observed lack of effect with low-dose aspirin may contribute to aspirin treatment failure in diabetes.
- Received July 20, 2011.
- Accepted October 21, 2011.
- © 2012 by the American Diabetes Association.
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