Platelet Reactivity, B-amyloid, MOTS-c and Mortality of Type II Diabetics With CAD

Study Overview
=================
Brief Summary
-----------------
Increased circulating b-amyloid and decreased Mitochondrial-derived peptide (MOTS-c), a peptide improving tissue insulin sensitivity, are reported in diabetes. The investigators plan to investigate the association of both biofactors with high on-clopidogrel platelet reactivity and cardiovascular mortality in type 2 diabetic patients with Coronary artery disease

Detailed Description
-----------------
In type II diabetic patients with Coronary artery disease treated with clopidogrel and aspirin, the investigators plan to measure: i. maximum platelet aggregation to adenosine diphosphate (ADP) by Light Transmission Aggregometry (LTAmax), as a marker of on-clopidogrel treatment platelet reactivity ii. Malondialdehyde (MDA), as oxidative stress marker, Mitochondrial-derived peptide MOTS-c and b-amyloid. blood levels.

Official Title
-----------------
High On-treatment Platelet Reactivity, Increased B-amyloid and Downregulation of MOTS-c Predict Mortality in Patients With Coronary Artery Disease and Type 2 Diabetes Mellitus: a 2-year Follow up Study

Conditions
-----------------
Diabetes, Clopidogrel Resistance, Amyloid, Insulin Resistance

Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: type 2 diabetic patients with coronary artery disease, documented by coronary angiography, both per os or/and parenteral antidiabetic medications and double antiplatelet therapy (DAPT), constituted by a daily dose of 100 mg acetylsalicylic acid per os and a daily dose of 75 mg clopidogrel per os should be prescribed to the patients for at least one month before inclusion in the study Exclusion Criteria: abnormal renal function (creatinine> 2.5 mg / dl), hepatic failure (bilirubin> 2 mg / dl), active malignancy, patients treated with drugs that affect platelet function, besides aspirin 100 mg qd and clopidogrel 75 mg qd, patients with a history of hemorrhagic mood, patients with thrombocytopenia (PLTs < 100x109 / L) and anemia (HCT <28%).

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------
What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mots-c predicts cardiovascular mortality in diabetic with coronary artery disease | mots-c concentration in Diabetic with coronary artery disease treated with acetyl-salicylic and clopidogrel predicts cardiovascular mortality | 2 year follow up | 
| b amyloid predicts cardiovascular mortality in diabetic with coronary artery disease | b amyloid concentration in Diabetic with coronary artery disease treated with acetyl-salicylic and clopidogrel predicts cardiovascular mortality | 2 year follow up | 
| b amyloid predicts cardiovascular mortality in diabetic with coronary artery | Resistance to clopidogrel as defined by Light Transmission Aggregometry in diabetic with coronary artery disease treated with acetyl-salicylic and clopidogrel predicts cardiovascular mortality. | 2 year follow up |