Dominick J. Angiolillo, MD, PhD: From the Division of Cardiology, University of Florida College of Medicine at Shands, Jacksonville, Florida.

Patients with type 2 diabetes mellitus have decreased platelet inhibition and decreased responsiveness to standard doses of clopidogrel compared with patients without diabetes. In this pilot study, we showed that increasing the maintenance dose of clopidogrel to 150 mg leads to enhanced platelet inhibition compared with the standard dose of 75 mg in patients with type 2 diabetes with suboptimal responsiveness. The clinical implications of these findings are unknown, however, and need to be evaluated in large-scale clinical trials.