OPTIMUS Study (Optimizing Antiplatelet Therapy in Diabetes Mellitus)

18 Mar, 14

OPTIMUS Study

Introduction

High maintenance dose of clopidogrel enhances platelet inhibition in patients of diabetes with CAD: Optimizing Antiplatelet Therapy in Diabetes Mellitus (OPTIMUS) Study

To assess the effect of a high maintenance dose of clopidogrel on platelet inhibition in type 2 diabetes patients with coronary artery disease (CAD) exhibiting suboptimal clopidogrel-induced antiplatelet effects

Patients

Diabetes and CAD with suboptimal clopidogrel responsiveness (defined as 20 mol/lt ADP- induced maximum platelet aggregation >50%) on maintenance therapy with 75 mg/day clopidogrel for at least 30 days and receiving concomitant 81 mg/day aspirin (N=40)

Patients receiving 150 mg clopidogrel experienced a significantly greater reduction in Aggmax compared to patients randomized to clopidogrel 75 mg as well as baseline (Figure 1)
Patients who received 75 mg clopidogrel did not exhibit any significant reduction in Aggmax as compared to baseline (Figure 1)

Figure 1. Comparison of Aggmax in study groups

Inhibition of maximal and late platelet aggregation was significantly greater in high maintenance dose group vs. patients receiving standard maintenance dose (Figure 2)

Figure 2. Inhibition of maximal (A) and late (B) platelet aggregation after stimulus with 20 mol/L and 5 mol/L ADP

Conclusions

Currently recommended maintenance dose of clopidogrel is associated with a high incidence of suboptimal response among patients with type 2 diabetes and CAD
A 150 mg maintenance dose of clopidogrel is associated with enhanced antiplatelet effects compared with 75 mg in high-risk type 2 diabetics

Circulation. 2007 Feb 13;115(6):708-16

OPTIMUS Study (Optimizing Antiplatelet Therapy in Diabetes Mellitus)

OPTIMUS Study

Introduction

Aim

Patients

Study Groups

Primary End-point

Results

Conclusions