Investigating Platelet Reactivity in Diabetic Patients of the Framingham Heart Study

Daniall Masood

Mentor: Dr. Melissa Chan, Senior Research Fellow at the Framingham Heart Study at The National Institutes of Health.

Date/Time: August 24, 2021 at 2:20pm

Abstract: The Framingham Heart Study (FHS) is an ongoing longitudinal cohort study that is studying cardiovascular disease (CVD) in 3 generations of participants. The FHS has identified different risk factors for CVD has allowed disease and mortality rates to drop over the years. Platelet reactivity and function has also been an area of study within these participants, since it has been shown that platelet reactivity is increased with patients with CVD. Platelets are important when vascular injury occurs and plays an important role in hemostasis and thrombosis. CVD is also the leading cause of death in diabetic patients. This research project focused on three different aims with the diabetic participants of the FHS. We aimed to observe if platelet reactivity was increased in participants with diabetes, if increased glucose levels led to an increase in platelet reactivity, and if anti-diabetic medications would cause a decrease in platelet reactivity in diabetics.

Blood samples were taken from consenting individuals and ran through different assays with different agonists that were known to induce platelet reaction and function. Once the data of platelet reactivity to these agonists was obtained, student t-tests and linear regression methods were used to observe the differences between the diabetic and non-diabetic groups and to see the correlation between the traits and the different features obtained from the study. We corrected for age, sex, and aspirin use across both groups. We observed two correlations that were statistically significant and were repeated among all the features. Platelet reactivity in response to TRAP-6 amide was increased in patients with diabetes and as glucose and HbA1C levels increased. Patients on anti-diabetic medications also showed increased platelet reactivity in response to TRAP-6 amide. Disaggregation of platelets in response to ADP was seen in diabetics and as glucose levels increased. This was a surprising result since ADP is a known agonist of platelet aggregation and amplification. This project highlights the importance of thrombin receptors in platelet reactivity within diabetic patients.