Abstract
Background: Cardiovascular complications account for the majority of deaths caused by diabetes mellitus. Platelet hyperactivity has been shown to increase the risk of thrombotic events and is a therapeutic target for their prevention in diabetes. Modulation of platelet function by diabetes agents in addition to their hypoglycemic effects would contribute to cardiovascular protection. Newly introduced antidiabetic drugs of sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 inhibitors may have anti-platelet effects, and in the case of SGLT2i and GLP-1RA may contribute to their proven cardiovascular benefit that has been shown clinically.
Objective: Here, we reviewed the potential effects of these agents on platelet function in diabetes.
Results and Conclusion: GLP-1RA and DPP-4i drugs have antiplatelet properties beyond their primary hypoglycemic effects. Whilst we have little direct evidence for the antiplatelet effects of SGLT2 inhibitors, some studies have shown that these agents may inhibit platelet aggregation and reduce the risk of thrombotic events in diabetes.
Keywords: Sodium-glucose cotransporter 2 inhibitors, glucagon like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors, diabetes mellitus, platelet, thrombosis, anti-diabetic drugs, cardiovascular.
Graphical Abstract
[http://dx.doi.org/10.2337/dc13-S067] [PMID: 23264425]
[http://dx.doi.org/10.1056/NEJMoa1610187] [PMID: 28402773]
[http://dx.doi.org/10.1002/jcp.28110] [PMID: 30623433]
[PMID: 30417367]
[http://dx.doi.org/10.1002/jcp.27278] [PMID: 30191997]
[http://dx.doi.org/10.1016/j.numecd.2016.05.007] [PMID: 27373139]
[http://dx.doi.org/10.1016/j.jdiacomp.2015.04.005] [PMID: 26026848]
[http://dx.doi.org/10.1055/s-2007-969025]
[http://dx.doi.org/10.1186/s12872-015-0124-z] [PMID: 26481314]
[http://dx.doi.org/10.2337/dc14-S081] [PMID: 24357215]
[http://dx.doi.org/10.2337/ds15-0047] [PMID: 27899877]
[http://dx.doi.org/10.2147/VHRM.S44469] [PMID: 25733843]
[http://dx.doi.org/10.1111/j.1365-2362.1994.tb02420.x] [PMID: 8013527]
[http://dx.doi.org/10.1055/s-0035-1570077]
[http://dx.doi.org/10.1161/ATVBAHA.113.302919] [PMID: 24371083]
[http://dx.doi.org/10.1038/nri3345] [PMID: 23222502]
[http://dx.doi.org/10.1038/nrc3004] [PMID: 21258396]
[http://dx.doi.org/10.1111/jth.12792] [PMID: 25403439]
[http://dx.doi.org/10.2337/dbi16-0014] [PMID: 27222394]
[http://dx.doi.org/10.1210/jc.2004-0745] [PMID: 15562034]
[http://dx.doi.org/10.2337/dc09-2013] [PMID: 20299485]
[http://dx.doi.org/10.1371/journal.pone.0192079] [PMID: 29389990]
[http://dx.doi.org/10.1053/euhj.2000.2515] [PMID: 11492985]
[PMID: 28948953]
[http://dx.doi.org/10.2337/diacare.24.8.1476] [PMID: 11473089]
[http://dx.doi.org/10.1161/01.HYP.37.4.1053] [PMID: 11304502]
[http://dx.doi.org/10.1016/j.prostaglandins.2015.05.002] [PMID: 25986598]
[http://dx.doi.org/10.3389/fphys.2014.00501] [PMID: 25601838]
[http://dx.doi.org/10.1093/eurheartj/ehp330] [PMID: 19687162]
[http://dx.doi.org/10.1073/pnas.95.9.4888] [PMID: 9560198]
[PMID: 30443936]
[http://dx.doi.org/10.3810/pgm.2014.10.2819] [PMID: 25414933]
[http://dx.doi.org/10.1002/jcp.28041] [PMID: 30710347]
[http://dx.doi.org/10.2337/diaclin.32.1.4] [PMID: 26246672]
[http://dx.doi.org/10.1002/jsfa.6779] [PMID: 24917557]
[http://dx.doi.org/10.1038/nrd3180] [PMID: 20508640]
[http://dx.doi.org/10.1136/bmjopen-2012-001007] [PMID: 23087012]
[http://dx.doi.org/10.1016/j.metabol.2015.10.010] [PMID: 26773934]
[http://dx.doi.org/10.2337/db07-1472] [PMID: 18356408]
[http://dx.doi.org/10.1111/dom.12187] [PMID: 23911013]
[http://dx.doi.org/10.1172/JCI72227] [PMID: 24463454]
[http://dx.doi.org/10.1016/S0140-6736(06)69705-5] [PMID: 17098089]
[http://dx.doi.org/10.1038/nrendo.2012.140] [PMID: 22945360]
[http://dx.doi.org/10.1053/j.gastro.2007.03.054] [PMID: 17498508]
[http://dx.doi.org/10.1152/ajpregu.00323.2007] [PMID: 17581835]
[http://dx.doi.org/10.1002/hep.21006] [PMID: 16374859]
[http://dx.doi.org/10.1124/jpet.110.176362] [PMID: 21075839]
[http://dx.doi.org/10.2337/dc18-S002] [PMID: 29222373]
[http://dx.doi.org/10.1016/j.beem.2007.07.005] [PMID: 18054733]
[http://dx.doi.org/10.1196/annals.1317.006] [PMID: 16888147]
[http://dx.doi.org/10.1016/j.redox.2017.06.009] [PMID: 28667906]
[http://dx.doi.org/10.1373/clinchem.2005.057414] [PMID: 16439610]
[http://dx.doi.org/10.1016/j.thromres.2011.04.018] [PMID: 21600632]
[http://dx.doi.org/10.1016/j.ijcard.2017.03.089] [PMID: 28395981]
[http://dx.doi.org/10.1161/CIRCULATIONAHA.116.021887] [PMID: 27470878]
[http://dx.doi.org/10.1016/S0735-1097(18)32393-3]
[http://dx.doi.org/10.2337/db09-1772] [PMID: 20484137]
[http://dx.doi.org/10.1111/bph.13831] [PMID: 28437857]
[http://dx.doi.org/10.1186/s12933-018-0750-8] [PMID: 30060748]
[http://dx.doi.org/10.1038/sj.ijir.3901256] [PMID: 15229623]
[http://dx.doi.org/10.2741/3228] [PMID: 19273051]
[http://dx.doi.org/10.1016/0968-0004(92)90008-W] [PMID: 1280869]
[http://dx.doi.org/10.1016/S0083-6729(08)60639-1]
[http://dx.doi.org/10.2337/db15-1141] [PMID: 26936963]
[http://dx.doi.org/10.1371/journal.pone.0082574] [PMID: 24376548]
[http://dx.doi.org/10.1007/s00726-015-1986-1] [PMID: 25929585]
[http://dx.doi.org/10.1016/j.atherosclerosis.2016.07.081]
[http://dx.doi.org/10.1038/aps.2011.149] [PMID: 22120969]
[http://dx.doi.org/10.1007/s00125-010-1831-8] [PMID: 20593161]
[PMID: 23193054]
[http://dx.doi.org/10.1210/en.2013-1096] [PMID: 23653460]
[http://dx.doi.org/10.1160/th14-03-0258] [PMID: 25030617]
[http://dx.doi.org/10.3109/09537104.2012.721907] [PMID: 22950787]
[http://dx.doi.org/10.1093/eurheartj/ehv301] [PMID: 26112890]
[PMID: 26251624]
[http://dx.doi.org/10.3810/pgm.2014.05.2756] [PMID: 24918792]
[http://dx.doi.org/10.3810/pgm.2013.05.2659] [PMID: 23748503]