 |
|
 |
- May 17, 2008 |
|
|
Welcome to the #1 online source of information for Diabetes Specialists! An international online community of more than 10,000 Diabetes Specialists.
CME on Diabetes is a website built to transmit top-level CME conferences given by international experts in endocrinology, insulin resistance, prediabetes, metabolic syndrome and type 2 diabetes. More than 2.6 million slides have been viewed since the website launch. Thank you for your continued support and commitment!
|
|
|
| Presentation |
|
"Diabetes Mellitus: A Prothrombotic State"Dr. Richard W. Nesto (biography)
English - 2005-05-11 - 38 minutes
|
 | (33 slides) |
Summary :
In this presentation Dr. Nesto talks about the mechanisms in diabetes that are responsible for the increased tendency to clot formation.
The higher risk of acute myocardial infarction in diabetes is hypothesized to be due to more extensive and progressive coronary artery disease, the proinflammatory and prothrombotic state of coronary plaques, as well as diabetes-specific non-plaque related factors, typically in circulating blood, that are responsible for an increased risk of thrombosis.
Apart from the known increased cardiovascular risk factors associated with insulin resistance and visceral adiposity, diabetic patients have certain plaque and blood abnormalities that contribute to a pro-thrombotic state. Superimposed thrombosis as a consequence of erosion of the fibrous cap is thought to be more common in diabetes for example, and Dr. Nesto presents some findings suggesting that the plaque of diabetic patients may be intrinsically different (1,2).
Increased circulating levels of tissue factor (3) and sCD40L (4) are seen in diabetes, as well as PAI-1, which is not only increased in the circulation but has also been found within the walls of coronary arteries (5). Dr. Nesto ends with a discussion of the increased platelet adhesion and aggregation seen in diabetes (6), and the effects of different anti-platelet therapies in diabetes.
Copyright © 2006 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Diabetes-associated changes in coronary plaques and blood contributing to thrombosis risk
- Effects of different anti-platelet therapies in diabetes
Bibliographic references :
1. Pedro R. Moreno, MD and Valentin Fuster, MD, PhD. New aspects in the pathogenesis of diabetic atherothrombosis J Am Coll Cardiol. 2004 Dec 21;44(12):2293-300.
2. Frank D. Kolodgie, Ph.D., Herman K. Gold, M.D., Allen P. Burke, M.D., David R. Fowler, M.D., Howard S. Kruth, M.D., Deena K. Weber, M.S., Andrew Farb, M.D., L.J. Guerrero, B.S., Motoya Hayase, M.D., Robert Kutys, M.S., Jagat Narula, M.D., Ph.D., Aloke V. Finn, M.D., and Renu Virmani, M.D. Intraplaque Hemorrhage and Progression of Coronary Atheroma. N Engl J Med. 2003 Dec 11;349(24):2316-25.
3. Antonia Sambola, MD; Julio Osende, MD; James Hathcock, PhD; Michael Degen, BSc; Yale Nemerson, MD; Valentin Fuster, MD, PhD; Jill Crandall, MD; Juan Jose Badimon, PhD. Role of Risk Factors in the Modulation of Tissue Factor Activity and Blood Thrombogenicity. Circulation. 2003;107:973.
4. Nerea Varo, PhD; David Vicent, MD, PhD; Peter Libby, MD; Rebecca Nuzzo, BSc; Alfonso L. Calle-Pascual, MD, PhD; María Rosa Bernal, PhD; Arturo Fernández-Cruz, MD, PhD; Aristidis Veves, MD, DSc; Petr Jarolim, MD, PhD; Jose Javier Varo, MD, PhD; Allison Goldfine, MD; Edward Horton, MD; Uwe Schönbeck, PhD. Elevated Plasma Levels of the Atherogenic Mediator Soluble CD40 Ligand in Diabetic Patients: A Novel Target of Thiazolidinediones. Circulation. 2003;107:2664.
5. Burton E. Sobel, MD; Janet Woodcock-Mitchell, PhD; David J. Schneider, MD; Robert E. Holt, BA; Kousuke Marutsuka, MD; ; Herman Gold, MD. Increased Plasminogen Activator Inhibitor Type 1 in Coronary Artery Atherectomy Specimens From Type 2 Diabetic Compared With Nondiabetic Patients: A Potential Factor Predisposing to Thrombosis and Its Persistence. Circulation. 1998;97:2213-2221.
6. John A. Colwell, MD, PHD and Richard W. Nesto, MD. The Platelet in Diabetes: Focus on prevention of ischemic events. Diabetes Care 26:2181-2188, 2003.
|
|
|
|
|
|
| Search our website |
 |
| |
Would you like to know more about insulin resistance? Are you looking for information pertaining to Type 2 Diabetes? You can find what you are looking for in over 2000 references available on CMEonDiabetes. |
| |
|
|
| Social |
|
| |
Let others know about this presentation.
|
|
|
|
