Interventional studies ● 12.2021 ● Prof. Dr. med. habil. Stefan Bornstein
Type 2 diabetes
Patients with type 2 diabetes mellitus and subclinical inflammation have stimulated coagulation, activated platelets, and endothelial dysfunction.
Recent studies with the direct factor Xa inhibitor rivaroxaban in combination with low-dose aspirin showed a significant reduction in serious cardiovascular events, particularly in individuals with type 2 diabetes and established cardiovascular disease. Therefore, the question was raised whether treatment with rivaroxaban could affect endothelial function, arterial stiffness, and platelet activation. A multicenter, prospective, randomized, open-label study was conducted in 179 participants with type 2 diabetes, subclinical inflammation (high-sensitivity C-reactive protein 2-10 mg/l), and at least two features of the metabolic syndrome. Twenty-week treatment with rivaroxaban (n = 89) resulted in significant improvement in forearm postischemic blood flow, numerically increased skin blood flow, and decreased plasma soluble P-selectin levels compared with aspirin. Significant differences in arterial stiffness or other biomarkers were not observed. Neither rivaroxaban nor aspirin affected platelet VASP phosphorylation. Rivaroxaban was associated with a higher number of bleeding events. These results suggest that the direct factor Xa inhibitor rivaroxaban improves endothelial function in participants with type 2 diabetes and subclinical inflammation but also increases bleeding risk.
Rivaroxaban compared with low-dose aspirin in individuals with type 2 diabetes and high cardiovascular risk: a randomised trial to assess effects on endothelial function, platelet activation and vascular biomarkers. Pistrosch F, Matschke JB, Schipp D, Schipp B, Henkel E, et al. Diabetologia. 2021 Dec;64(12):2701-2712.
GWT-TUD GmbH, Innovation Center Endocrinology and Metabolic Medicine, Dresden, Germany and Medical Clinic III, Faculty of Medicine, Technical University, Dresden, Germany.
Prof. Dr. med. Stefan Bornstein
Innovation Center Endocrinology and Metabolic Medicine, GWT-TUD GmbH
Medical Clinic III
Technical University Dresden
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