The Effect of Dapagliflozin on Platelet Function Testing Profiles in Diabetic Patients: The EDGE Pilot Study

Naveen Seecheran, Kathryn Grimaldos, Kabeer Ali, Gabriella Grimaldos, Srivane Richard, Aleena Ishmael, Ceylon Gomes, Abhinav Karan, Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Harun Abdullah, Lakshmipathi Peram, Darren Dookeeram, Stanley Giddings, Shastri Motilal, Sadi Raza, Antonio Tello-Montoliu, David Schneider, Naveen Seecheran, Kathryn Grimaldos, Kabeer Ali, Gabriella Grimaldos, Srivane Richard, Aleena Ishmael, Ceylon Gomes, Abhinav Karan, Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Harun Abdullah, Lakshmipathi Peram, Darren Dookeeram, Stanley Giddings, Shastri Motilal, Sadi Raza, Antonio Tello-Montoliu, David Schneider

Abstract

Introduction: This prospective pharmacodynamic (PD) study assessed the effect of the sodium-glucose co-transporter-2 inhibitor (SGLT2i), dapagliflozin, on platelet reactivity.

Methods: Patients with stable coronary artery disease (CAD) and type 2 diabetes mellitus (T2DM) (n = 27) who were on maintenance dual antiplatelet therapy (DAPT) of aspirin 81 mg daily, and clopidogrel 75 mg daily were recruited. Platelet function was evaluated with the VerifyNow™ P2Y12 assay (Werfen, Bedford, MA, USA) and assessed prior to initiation of and after 10 days of treatment with dapagliflozin 10 mg once-daily dose regimen. Results were compared with a paired t test.

Results: Treatment with dapagliflozin significantly decreased P2Y12 reaction units (PRU) by 20%, (95% confidence interval (CI) 8.5-32.6%, p value 0.002). The mean difference in PRU was 36.70 (95% CI 16.66-56.75). No patients experienced any serious adverse events (SAEs).

Conclusions: Significantly diminished platelet reactivity was observed on dapagliflozin as compared to without dapagliflozin. This dedicated pharmacodynamic study could be potentially informative and applicable for Trinidadian stable CAD patients with T2DM on DAPT. Further studies are required to confirm these exploratory findings.

Clinical trial registration: EDGE ClinicalTrials.gov number NCT04400760.

Keywords: Dapagliflozin; Platelet function; Platelet reactivity; Sodium-glucose co-transporter 2 inhibitor (SGLT2i); VerifyNow™.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Methodology outline
Fig. 2
Fig. 2
Comparison of patients’ P2Y12 reaction units (PRU) before and after dapagliflozin 10 mg

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