High-dose aspirin is required to influence plasma fibrin network structure in patients with type 1 diabetes

Abstract

OBJECTIVE - Patients with type 1 diabetes forma 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 [HbA 1c <7.4%] and 24 subjects with poor [HbA 1c >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 (K s). RESULTS - Treatment with 75 mg aspirin did not influence fibrin network permeability (K s). However, K s 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 K s during high-dose aspirin treatment was significant in patients with poor glycemic control (P = 0.02), whereas K s 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. © 2012 by the American Diabetes Association.