The document discusses antithrombotic strategies for patients with diabetes who are at risk of cardiovascular events. It proposes strategies for primary prevention, stable coronary artery disease, acute coronary syndromes, ischemic stroke, peripheral artery disease, atrial fibrillation, and venous thromboembolism. More aggressive antithrombotic therapies are associated with greater reduction in recurrent cardiovascular events for patients with diabetes. However, these strategies must be weighed against the risk of bleeding. Further clinical trials are still needed to better understand optimal antithrombotic treatment for cardiovascular patients with diabetes.

1. Dr.Omed Hawramy

2. Introduction:
DM is an important risk factor for a first CV event & for worse outcomes
after such event.
It is caused, by the prothrombotic status observed in DM.
Contemporary antithrombotic strategies, including more potent agents or
drug combinations, provide greater clinical benefit in DM.
We propose antithrombotic strategies for patients with diabetes in various
cardiovascular settings(primary prevention, stable coronary artery
disease, acute coronary syndromes, ischaemic stroke &TIA, PAD,
AF&venous thromboembolism).
We summarize the improvements in CV outcomes with the latest glucose-
lowering drugs, and on the basis of the available evidence,
We expand / integrate current guideline recommendations on
antithrombotic strategies in patients with diabetes for both primary &
secondary prevention of CVD.

16. Conclusion:
Patients with DM have a prothrombotic state & a higher risk of CV events.
Antithrombotic therapies is associated with a higher absolute reduction of
recurrent events.
More aggressive antithrombotic strategies is specifically indicated in
patients with diabetes &CVD, including the use of the newer, more potent
P2Y12 inhibitors in patients with ACS, DAPT prolongation beyond 1 year
in patients with MI&short-term DAPT in selected patients with acute
ischaemic stroke,but must always be weighed against the risk of drug-
related bleeding.
Available evidence on the efficacy & safety of antithrombotic drugs in
patients with diabetes at risk of or with CVD is encouraging but needs
further trials.