Impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease patients complicated with end-stage renal disease
© 2024. The Author(s)..
It is controversial whether hemodialysis affects the efficacy of the antiplatelet agents. We aimed to investigate the impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease (CAD) patients complicated with end-stage renal disease (ESRD). 86 CAD patients complicated with ESRD requiring hemodialysis were consecutively enrolled. After 5-day treatment with aspirin and clopidogrel or ticagrelor, the platelet aggregations induced by arachidonic acid (PLAA) or adenosine diphosphate (PLADP), and the P2Y12 reaction unit (PRU) were measured before and after hemodialysis. The propensity matching score method was adopted to generate a control group with normal renal function from 2439 CAD patients. In patients taking aspirin, the PLAA remained unchanged after hemodialysis. In patients taking clopidogrel, the PLADP (37.26 ± 17.04 vs. 31.77 ± 16.09, p = 0.029) and corresponding clopidogrel resistance (CR) rate (23 [48.9%] vs. 14 [29.8%], p = 0.022) significantly decreased after hemodialysis, though PRU remained unchanged. Subgroup analysis indicated that PLADP significantly decreased while using polysulfone membrane (36.8 ± 17.9 vs. 31.1 ± 14.5, p = 0.024). In patients taking ticagrelor, PLADP, and PRU remained unchanged after hemodialysis. ESRD patients had higher incidences of aspirin resistance (AR) and CR compared to those with normal renal function (AR: 16.1% vs. 0%, p = 0.001; CR: 48.4% vs. 24.8%, p = 0.024). Hemodialysis does not have negative effect on the efficacies of aspirin, clopidogrel and ticagrelor in ESRD patients with CAD. ESRD patients have higher incidences of AR and CR compared with those with normal renal function.Trial registration ClinicalTrials.gov Identifier: NCT03330223, first registered January 4, 2018.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:57 |
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| Enthalten in: |
Journal of thrombosis and thrombolysis - 57(2024), 4 vom: 26. Apr., Seite 558-565 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ye, Zekang [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 19.04.2024 Date Revised 26.04.2024 published: Print-Electronic ClinicalTrials.gov: NCT03330223 Citation Status MEDLINE |
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| doi: |
10.1007/s11239-023-02924-5 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease patients complicated with end-stage renal disease |
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| 500 | |a ClinicalTrials.gov: NCT03330223 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024. The Author(s). | ||
| 520 | |a It is controversial whether hemodialysis affects the efficacy of the antiplatelet agents. We aimed to investigate the impact of hemodialysis on efficacies of the antiplatelet agents in coronary artery disease (CAD) patients complicated with end-stage renal disease (ESRD). 86 CAD patients complicated with ESRD requiring hemodialysis were consecutively enrolled. After 5-day treatment with aspirin and clopidogrel or ticagrelor, the platelet aggregations induced by arachidonic acid (PLAA) or adenosine diphosphate (PLADP), and the P2Y12 reaction unit (PRU) were measured before and after hemodialysis. The propensity matching score method was adopted to generate a control group with normal renal function from 2439 CAD patients. In patients taking aspirin, the PLAA remained unchanged after hemodialysis. In patients taking clopidogrel, the PLADP (37.26 ± 17.04 vs. 31.77 ± 16.09, p = 0.029) and corresponding clopidogrel resistance (CR) rate (23 [48.9%] vs. 14 [29.8%], p = 0.022) significantly decreased after hemodialysis, though PRU remained unchanged. Subgroup analysis indicated that PLADP significantly decreased while using polysulfone membrane (36.8 ± 17.9 vs. 31.1 ± 14.5, p = 0.024). In patients taking ticagrelor, PLADP, and PRU remained unchanged after hemodialysis. ESRD patients had higher incidences of aspirin resistance (AR) and CR compared to those with normal renal function (AR: 16.1% vs. 0%, p = 0.001; CR: 48.4% vs. 24.8%, p = 0.024). Hemodialysis does not have negative effect on the efficacies of aspirin, clopidogrel and ticagrelor in ESRD patients with CAD. ESRD patients have higher incidences of AR and CR compared with those with normal renal function.Trial registration ClinicalTrials.gov Identifier: NCT03330223, first registered January 4, 2018 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Antiplatelet therapy | |
| 650 | 4 | |a Coronary artery disease | |
| 650 | 4 | |a End-stage renal disease | |
| 650 | 4 | |a Hemodialysis | |
| 650 | 7 | |a Platelet Aggregation Inhibitors |2 NLM | |
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| 650 | 7 | |a Ticagrelor |2 NLM | |
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| 650 | 7 | |a Ticlopidine |2 NLM | |
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| 650 | 7 | |a Aspirin |2 NLM | |
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| 650 | 7 | |a Adenosine Diphosphate |2 NLM | |
| 650 | 7 | |a 61D2G4IYVH |2 NLM | |
| 700 | 1 | |a Wang, Qin |e verfasserin |4 aut | |
| 700 | 1 | |a Ullah, Inam |e verfasserin |4 aut | |
| 700 | 1 | |a Lin, Qingxia |e verfasserin |4 aut | |
| 700 | 1 | |a Wu, Tianyu |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Mingwen |e verfasserin |4 aut | |
| 700 | 1 | |a Fan, Yuansheng |e verfasserin |4 aut | |
| 700 | 1 | |a Dong, Zhou |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Tong |e verfasserin |4 aut | |
| 700 | 1 | |a Teng, Jianzhen |e verfasserin |4 aut | |
| 700 | 1 | |a Hua, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Yingdan |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Yule |e verfasserin |4 aut | |
| 700 | 1 | |a Gong, Xiaoxuan |e verfasserin |4 aut | |
| 700 | 1 | |a Yuan, Liang |e verfasserin |4 aut | |
| 700 | 1 | |a Tao, Zhengxian |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Chunjian |e verfasserin |4 aut | |
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