Platelet Activation Markers in Patients with Type 2 Diabetes and Cardiovascular Complications at a Teaching Hospital in Imo State, South East Nigeria

This study evaluates platelet activation markers in type 2 diabetes mellitus (T2DM) patients with and without cardiovascular complications at Federal University Teaching Hospital, Owerri, Imo State, South East Nigeria, addressing the haemostatic mechanisms underlying excess cardiovascular risk in Nigerian diabetic patients. A case-control design enrolled 80 T2DM patients with confirmed cardiovascular complications (myocardial infarction, stroke, or peripheral artery disease), 80 T2DM patients without cardiovascular complications, and 80 non-diabetic controls. Platelet surface expression of P-selectin (CD62P) and glycoprotein IIb/IIIa (CD41a) was measured by flow cytometry as direct activation markers. Platelet-monocyte aggregates were quantified as a measure of thromboinflammatory activation. MPV, PDW, and platelet-to-lymphocyte ratio were assessed alongside HbA1c and fasting glucose. Flow cytometric P-selectin expression was significantly higher in diabetic patients with cardiovascular complications compared to both diabetic controls and non-diabetic controls. Platelet-monocyte aggregate frequency correlated strongly with HbA1c levels. T2DM patients with HbA1c above 9 percent showed CD62P expression levels comparable to those seen after experimental platelet stimulation. PDW and MPV correlated with flow cytometric activation markers. These findings demonstrate that glycaemic control quality directly modulates platelet activation intensity in Nigerian T2DM patients. The study recommends integrating platelet activation monitoring into cardiovascular risk assessment for diabetic patients at FUTO and proposes HbA1c as a practical surrogate for platelet hyperactivation risk. Keywords: platelet activation, type 2 diabetes, cardiovascular complications, flow cytometry, Imo State.