Antiplatelet agents for chronic kidney disease
- PMID: 35224730
- PMCID: PMC8883339
- DOI: 10.1002/14651858.CD008834.pub4
Antiplatelet agents for chronic kidney disease
Abstract
Background: Antiplatelet agents are widely used to prevent cardiovascular events. The risks and benefits of antiplatelet agents may be different in people with chronic kidney disease (CKD) for whom occlusive atherosclerotic events are less prevalent, and bleeding hazards might be increased. This is an update of a review first published in 2013.
Objectives: To evaluate the benefits and harms of antiplatelet agents in people with any form of CKD, including those with CKD not receiving renal replacement therapy, patients receiving any form of dialysis, and kidney transplant recipients.
Search methods: We searched the Cochrane Kidney and Transplant Register of Studies up to 13 July 2021 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov.
Selection criteria: We selected randomised controlled trials of any antiplatelet agents versus placebo or no treatment, or direct head-to-head antiplatelet agent studies in people with CKD. Studies were included if they enrolled participants with CKD, or included people in broader at-risk populations in which data for subgroups with CKD could be disaggregated.
Data collection and analysis: Four authors independently extracted data from primary study reports and any available supplementary information for study population, interventions, outcomes, and risks of bias. Risk ratios (RR) and 95% confidence intervals (CI) were calculated from numbers of events and numbers of participants at risk which were extracted from each included study. The reported RRs were extracted where crude event rates were not provided. Data were pooled using the random-effects model. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Main results: We included 113 studies, enrolling 51,959 participants; 90 studies (40,597 CKD participants) compared an antiplatelet agent with placebo or no treatment, and 29 studies (11,805 CKD participants) directly compared one antiplatelet agent with another. Fifty-six new studies were added to this 2021 update. Seven studies originally excluded from the 2013 review were included, although they had a follow-up lower than two months. Random sequence generation and allocation concealment were at low risk of bias in 16 and 22 studies, respectively. Sixty-four studies reported low-risk methods for blinding of participants and investigators; outcome assessment was blinded in 41 studies. Forty-one studies were at low risk of attrition bias, 50 studies were at low risk of selective reporting bias, and 57 studies were at low risk of other potential sources of bias. Compared to placebo or no treatment, antiplatelet agents probably reduces myocardial infarction (18 studies, 15,289 participants: RR 0.88, 95% CI 0.79 to 0.99, I² = 0%; moderate certainty). Antiplatelet agents has uncertain effects on fatal or nonfatal stroke (12 studies, 10.382 participants: RR 1.01, 95% CI 0.64 to 1.59, I² = 37%; very low certainty) and may have little or no effect on death from any cause (35 studies, 18,241 participants: RR 0.94, 95 % CI 0.84 to 1.06, I² = 14%; low certainty). Antiplatelet therapy probably increases major bleeding in people with CKD and those treated with haemodialysis (HD) (29 studies, 16,194 participants: RR 1.35, 95% CI 1.10 to 1.65, I² = 12%; moderate certainty). In addition, antiplatelet therapy may increase minor bleeding in people with CKD and those treated with HD (21 studies, 13,218 participants: RR 1.55, 95% CI 1.27 to 1.90, I² = 58%; low certainty). Antiplatelet treatment may reduce early dialysis vascular access thrombosis (8 studies, 1525 participants) RR 0.52, 95% CI 0.38 to 0.70; low certainty). Antiplatelet agents may reduce doubling of serum creatinine in CKD (3 studies, 217 participants: RR 0.39, 95% CI 0.17 to 0.86, I² = 8%; low certainty). The treatment effects of antiplatelet agents on stroke, cardiovascular death, kidney failure, kidney transplant graft loss, transplant rejection, creatinine clearance, proteinuria, dialysis access failure, loss of primary unassisted patency, failure to attain suitability for dialysis, need of intervention and cardiovascular hospitalisation were uncertain. Limited data were available for direct head-to-head comparisons of antiplatelet drugs, including prasugrel, ticagrelor, different doses of clopidogrel, abciximab, defibrotide, sarpogrelate and beraprost.
Authors' conclusions: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD and those treated with dialysis. The treatment effects of antiplatelet agents compared with each other are uncertain.
Trial registration: ClinicalTrials.gov NCT01709994 NCT01155765 NCT01090037 NCT00979589 NCT00050817 NCT00776828 NCT00067119 NCT03289520 NCT00089895 NCT00110448 NCT01252056 NCT02578537 NCT01225562 NCT01328470 NCT02163954 NCT02406911 NCT00391872 NCT00234585 NCT02022748 NCT00526474 NCT00527943 NCT00097591 NCT00496769 NCT01082874 NCT00611286 NCT01173666 NCT00059306 NCT00320008 NCT00699998 NCT02663713 NCT03387826 NCT03796156 NCT02895113 NCT01198379 NCT01743014 NCT02394145 NCT02459288 NCT03039205 NCT03150667 NCT03649711 NCT01165567 NCT02294643 NCT01869881 NCT03357874.
Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Conflict of interest statement
Editorial contributions
Sign‐off Editor (final editorial decision): Dr Elisabeth Hodson
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Comment in
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Antiplatelet Therapy in Chronic Kidney Disease.Am Fam Physician. 2022 Dec;106(6):624-625. Am Fam Physician. 2022. PMID: 36521459 No abstract available.
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EPILOG 1997 {unpublished data only}
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EPISTENT 1998 {unpublished data only}
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- Cho L, Marso SP, Bhatt DL, Topol EJ.Optimizing percutaneous coronary revascularization in diabetic women: analysis from the EPISTENT trial. Journal of Womens Health & Gender-Based Medicine 2000;9(7):741-6. [MEDLINE: ] - PubMed
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ETDRS 1992 {unpublished data only}
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EUCLID 2017 {published data only}
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- Baumgartner I, Norgren L, Fowkes FG, Mulder H, Patel MR, Berger JS, et al.Cardiovascular outcomes after lower extremity endovascular or surgical revascularization: the EUCLID trial. Journal of the American College of Cardiology 2018;72(14):1563-72. [MEDLINE: ] - PubMed
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Frascà 1997 {published data only}
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Gaede 2003 {published data only}
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- Gaede P, Hansen HP, Parving HH, Pedersen O.Impact of low-dose acetylsalicylic acid on kidney function in type 2 diabetic patients with elevated urinary albumin excretion rate. Nephrology Dialysis Transplantation 2003;18(3):539-42. [MEDLINE: ] - PubMed
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Ghorbani 2009 {published data only}
Ghorbani 2013 {published data only}
Giustina 1998 {published data only}
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- Giustina A, Perini P, Desenzani P, Bossoni S, Ianniello P, Milani M, et al.Long-term treatment with the dual antithromboxane agent picotamide decreases microalbuminuria in normotensive type 2 diabetic patients. Diabetes 1998;47(3):423-30. [MEDLINE: ] - PubMed
GLOBAL LEADERS 2018 {published data only}
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- Tomaniak M, Chichareon P, Klimczak-Tomaniak D, Takahashi K, Kogame N, Modolo R, et al.Impact of renal function on clinical outcomes after PCI in ACS and stable CAD patients treated with ticagrelor: a prespecified analysis of the GLOBAL LEADERS randomized clinical trial. Clinical Research in Cardiology 2020;109(7):930-43. [MEDLINE: ] - PubMed
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Goicoechea 2012 {published data only}
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- Morales AM, Goicoechea M, Verde E, Carbayo J, Barbieri D, Delgado A, et al.Pentoxifylline, progression of chronic kidney disease (CKD) and cardiovascular mortality: long-term follow-up of a randomized clinical trial. Journal of Nephrology 2019;32(4):581-7. [MEDLINE: ] - PubMed
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Gonzalez 1995 {published data only}
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Gröntoft 1985 {published data only}
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- Guo Z, Hasbach J, Koschinsky T.Effect of acetylsalicylic acid on renal function of Type 1 diabetic patients with microalbuminuria [Wirkung von Azetylsalizylsaure auf die Nierenfunktion bei Typ-1- Diabetikern mit Mikroalbuminurie. Placebokontrollierte Crossover-Pilotstudie]. Diabetes und Stoffwechsel 1998;7(2):41-7. [EMBASE: 28146337]
Hansen 2000 {published data only}
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- Hansen HP, Gaede PH, Jensen BR, Parving HH.Lack of impact of low-dose acetylsalicylic acid on kidney function in type 1 diabetic patients with microalbuminuria. Diabetes Care 2000;23(12):1742-5. [MEDLINE: ] - PubMed
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Hidaka 2013 {published data only}
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- Hidaka S, Kobayashi S, Iwagami M, Isshiki R, Tsutsumi D, Mochida Y, et al.Sarpogrelate hydrochloride, a selective 5-HT(2A) receptor antagonist, improves skin perfusion pressure of the lower extremities in hemodialysis patients with peripheral arterial disease. Renal Failure 2013;35(1):43-8. [MEDLINE: ] - PubMed
HOT 1993 {published and unpublished data}
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IMPACT II 1997 {unpublished data only}
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- Blankenship JC, Sigmon KN, Pieper KS, O'Shea C, Tardiff BE, Tcheng JE, et al.Effect of eptifibatide on angiographic complications during percutaneous coronary intervention in the IMPACT--(Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis) II Trial. American Journal of Cardiology 2001;88(9):969-73. [MEDLINE: ] - PubMed
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Jiao 2013 {published data only}
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JPAD 2008 {published data only}
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- Ogawa H, Nakayama M, Morimoto T, Uemura S, Kanauchi M, Doi N, et al.Low-dose aspirin for primary prevention of atherosclerotic events in patients with type 2 diabetes: a randomized controlled trial.[Erratum in: JAMA. 2009 May 13;301(18):1882], [Erratum in: JAMA. 2012 Nov 14;308(18):1861]. JAMA 2008;300(18):2134-41. [MEDLINE: ] - PubMed
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- Ohtake T, Sato M, Nakazawa R, Kondoh M, Kobayashi S.Effect of beraprost sodium (PGI2 analogue) on peripheral arterial disease (PAD) in patients on hemodialysis: result from a multicenter randomized prospective interventional study [abstract no: Su528]. NDT Plus 2010;3(Suppl 3):iii487. [EMBASE: 70484748]
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Kamper 1997 {published data only}
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Kaufman 2003 {published and unpublished data}
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Khajehdehi 2002 {published data only}
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Kobayashi 1980 {published data only}
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- Kobayashi K, Maeda K, Koshikawa S, Kawaguchi Y, Shimizu N, Naito C.Antithrombotic therapy with ticlopidine in chronic renal failure patients on maintenance hemodialysis: a multicenter collaborative double blind study. Thrombosis Research 1980;20(2):255-61. [MEDLINE: ] - PubMed
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Liang 2015 {published data only}
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- Liang J, Wang Z, Shi D, Liu Y, Zhao Y, Han H, et al.High clopidogrel dose in patients with chronic kidney disease having clopidogrel resistance after percutaneous coronary intervention. Angiology 2015;66(4):319-25. [MEDLINE: ] - PubMed
Michie 1977 {published data only}
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Mozafar 2018 {published data only}
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Nyberg 1984 {published data only}
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OPT‐CKD 2018 {published data only}
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Ota 1996 {published data only}
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PEGASUS‐TIMI 54 2014 {published data only}
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- Bonaca MP, Bhatt DL, Braunwald E, Cohen M, Steg PG, Storey RF, et al.Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. American Heart Journal 2014;167(4):437-44. [MEDLINE: ] - PubMed
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PIANO‐2 CKD 2011 {published data only}
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- Kim W, Kang WY, Woo JS.Objectives: The purpose of this study was to determine the functional impact of cilostazol in patients with chronic kidney disease (CKD) undergoing hemodialysis [abstract no: TCT-497]. Journal of the American College of Cardiology 2011;58(20 Suppl 1):B135. [EMBASE: 70581866]
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- Woo JS, Kim W, Ha SJ, Jeong KH, Lee TW, Ihm CG, et al.A comparison of clopidogrel responsiveness in patients with chronic renal failure: results of the adjunctive cilostazol versus high maintenance dose clopidogrel (PIANO) study [abstract no: AS-252]. American Journal of Cardiology 2011;107(8 Suppl 1):100-1A. [EMBASE: 70401953]
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- Woo JS, Kim W, Lee SR, Jung KH, Kim WS, Lew JH, et al.Platelet reactivity in patients with chronic kidney disease receiving adjunctive cilostazol compared with a high-maintenance dose of clopidogrel: results of the effect of platelet inhibition according to clopidogrel dose in patients with chronic kidney disease (PIANO-2 CKD) randomized study. American Heart Journal 2011;162(6):1018-25. [MEDLINE: ] - PubMed
PIANO‐3 2015 {published data only}
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- Jeong KH, Cho JH, Woo JS, Kim JB, Kim WS, Lee TW, et al.Platelet reactivity after receiving clopidogrel compared with ticagrelor in patients with kidney failure treated with hemodialysis: a randomized crossover study. American Journal of Kidney Diseases 2015;65(6):916-24. [MEDLINE: ] - PubMed
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- Woo JS, Kim W, Kim HS, Hwang SJ, Kim JB, Kim SJ, et al.Randomized assessment of the onset and offset of the antiplatelet effects of ticagrelor versus clopidogrel in patients with chronic kidney disease performing hemodialysis [abstract]. European Heart Journal 2014;35(Suppl 1):7-8. [EMBASE: 71646762]
PIANO‐6 2017 {published data only}
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- Kim JS, Lee TW, Ihm C, Lee SH, Kim SY, Lee SY, et al.Relationship of ticagrelor dose and platelet reactivity in patients with end stage renal disease on hemodialysis [abstract no: FR-PO727]. Journal of the American Society of Nephrology 2015;26(Abstract Suppl):529A.
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- Kim JS, Woo JS, Kim JB, Kim WS, Lee TW, Kim KS, et al.The pharmacodynamics of low and standard doses of ticagrelor in patients with end stage renal disease on hemodialysis. International Journal of Cardiology 2017;238:110-6. [MEDLINE: ] - PubMed
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- Kim W, Woo JS, Kim WS, Kim JB, Kim HO, Kim JM.Pharmacodynamics of low and standard doses of ticagrelor in patients with end stage renal disease on hemodialysis [abstract]. European Heart Journal 2016;37(Suppl 1):636. [EMBASE: 612284362]
Pierucci 1989 {published data only}
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PLATO 2009 {published data only}
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- Akerblom A, Wallentin L, Larsson A, Siegbahn A, Becker RC, Budaj A, et al.Cystatin C- and creatinine-based estimates of renal function and their value for risk prediction in patients with acute coronary syndrome: results from the PLATelet Inhibition and Patient Outcomes (PLATO) study. Clinical Chemistry 2013;59(9):1369-75. [MEDLINE: ] - PubMed
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- Akerblom A, Wallentin L, Siegbahn A, Becker RC, Budaj A, Horrow J, et al.Outcome and causes of renal deterioration evaluated by serial cystatin C measurements in acute coronary syndrome patients -- results from the PLATelet inhibition and patient Outcomes (PLATO) study. American Heart Journal 2012;164(5):728-34. [MEDLINE: ] - PubMed
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- Armstrong PW, Westerhout CM, Fu Y, Harrington RA, Storey RF, Katus H, et al.Quantitative ST-depression in acute coronary syndromes: the PLATO electrocardiographic substudy. American Journal of Medicine 2013;126(8):723-9. [MEDLINE: ] - PubMed
PREDIAN 2011 {published data only}
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- Navarro-Gonzalez JF, Sanchez-Nino MD, Donate-Correa J, Martin-Nunez E, Ferri C, Perez-Delgado N, et al.Effects of pentoxifylline on soluble klotho concentrations and renal tubular cell expression in diabetic kidney disease. Diabetes Care 2018;41(8):1817-20. [MEDLINE: ] - PubMed
PRISM‐PLUS 1998 {published data only (unpublished sought but not used)}
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- Huynh T, Nasmith J, Luong TM, Bernier M, Pharand C, Xue-Qiao Z, et al.Complementary prognostic values of ST segment deviation and Thrombolysis In Myocardial Infarction (TIMI) risk score in non-ST elevation acute coronary syndromes: insights from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study. Canadian Journal of Cardiology 2009 Dec;25(12):e417-21. [MEDLINE: ] - PMC - PubMed
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- Januzzi JL Jr, Snapinn SM, DiBattiste PM, Jang IK, Theroux P.Benefits and safety of tirofiban among acute coronary syndrome patients with mild to moderate renal insufficiency: results from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) trial. Circulation 2002;105(20):2361-6. [MEDLINE: ] - PubMed
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PURSUIT 1997 {unpublished data only}
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- Akkerhuis KM, Deckers JW, Boersma E, Harrington RA, Stepinska J, Mahaffey KW, et al.Geographic variability in outcomes within an international trial of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes. Results from PURSUIT. European Heart Journal 2000;21(5):371-81. [MEDLINE: ] - PubMed
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- Alexander JH, Harrington RA, Tuttle RH, Berdan LG, Lincoff AM, Deckers JW, et al.Prior aspirin use predicts worse outcomes in patients with non-ST-elevation acute coronary syndromes. PURSUIT Investigators. Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy. American Journal of Cardiology 1999;83(8):1147-51. [MEDLINE: ] - PubMed
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Quarto Di Palo 1991 {published data only}
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- Quarto Di Palo F, Elli A, Rivolta R, Parenti M, Palazzi P, Zanussi C.Prevention of chronic cyclosporine nephrotoxicity in renal transplantation by picotamide. Transplantation Proceedings 1991;23(1 Pt 2):969-71. [MEDLINE: ] - PubMed
RAPPORT 1998 {published and unpublished data}
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Reams 1985 {published data only}
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RESIST 2008 {published data only}
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Rouzrokh 2010 {published data only}
Rubin 1982 {published data only}
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- Rubin J, Adair C, Barnes T, Bower JD.Augmentation of peritoneal clearance by dipyridamole. Kidney International 1982;22(6):658-61. [MEDLINE: ] - PubMed
Salter 1984 {published data only}
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Schnepp 2000 {published data only}
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Schulze 1990 {published data only}
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Sreedhara 1994 {published data only}
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- Sreedhara R, Himmelfarb J, Lazarus JM, Hakim RM.Antiplatelet therapy in expanded polytetrafluoroethylene (EPTFE) graft thrombosis: results of a randomized double blind study [abstract no: 9P]. Journal of the American Society of Nephrology 1993;4(Program & Abstracts):388. [CENTRAL: CN-00485981]
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Steiness 2018 {published data only}
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- Steiness E, Brun N, Skarsfeldt T, Derwahl KM.Low dose anti-thromboxane reduces urinary albumin in patients with diabetic kidney disease [abstract no: SA-PO148]. Journal of the American Society of Nephrology 2018;29:773. [EMBASE: 633731990]
STOP 1995 {published and unpublished data}
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Storck 1996 {published data only}
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- Storck M, Schilling M, Mickley V, Techt B, Abendroth D.Influence of systemic cyclooxygenase inhibition with single-dose aspisol on kinetics of arachidonic acid metabolites in the venous effluate of transplanted kidney grafts in humans. Transplantation Proceedings 1996;28(1):312-3. [MEDLINE: ] - PubMed
Taber 1992 {published data only}
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- Taber T, Maikranz P, Haag B, Dilley R, Gaylord G.Hemodialysis vascular graft stenosis may be altered by low-molecular weight dextran (LMD), but not by aspirin (ASA) [abstract]. Journal of the American Society of Nephrology 1992;3(3):397. [CENTRAL: CN-00858239]
Tang 2014 {published data only}
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- Tang WH, Lin FH, Lee CH, Kuo FC, Hsieh CH, Hsiao FC, et al.Cilostazol effectively attenuates deterioration of albuminuria in patients with type 2 diabetes: a randomized, placebo-controlled trial. Endocrine 2014;45(2):293-301. [MEDLINE: ] - PubMed
TARGET 2000 {published and unpublished data}
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- Berger PB, Best PJ, Topol EJ, White J, DiBattiste PM, Chan AW, et al.The relation of renal function to ischemic and bleeding outcomes with 2 different glycoprotein IIb/IIIa inhibitors: the do Tirofiban and ReoPro Give Similar Efficacy Outcome (TARGET) trial. American Heart Journal 2005;149(5):869-75. [MEDLINE: ] - PubMed
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Tayebi 2018 {published data only}
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- Tayebi P, Kazemzadeh G, Banihashem A, Ravari H.Effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients: a randomized double-blind placebo-controlled trial. Electronic Physician [Electronic Resource] 2018;10(1):6135-9. [MEDLINE: ] - PMC - PubMed
Teng 2018 {published data only}
TRA 2P‐TIMI 50 2009 {published data only}
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TRACER 2013 {published data only}
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TRITON‐TIMI 38 2006 {unpublished data only}
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- Abaci A.The use of prasugrel in STEMI and NSTEMI: TRITON TIMI 38 study and subgroup analyses [Prasugrelin ST yukselmeli ve yukselmesiz miyokart enfarktusunde kullanimi: TRITON TIMI 38 caIismasi ve alt grup sonuclari]. Turk Kardiyoloji Dernegi Arsivi 2015;43 Suppl 2:1-6. [MEDLINE: ] - PubMed
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UK‐HARP‐I 2005 {published and unpublished data}
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Waseda 2016 {published data only}
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Watanabe 2011b {published data only}
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Weseley 1982 {published data only}
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Xydakis 2004 {published data only}
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Yang 2016b {published data only}
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Yuto 2012 {published data only}
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Zäuner 1994 {published data only}
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- Zäuner I, Böhler J, Braun N, Grupp C, Heering P, Schollmeyer P.Effect of aspirin and dipyridamole on proteinuria in idiopathic membranoproliferative glomerulonephritis: a multicentre prospective clinical trial. Nephrology Dialysis Transplantation 1994;9(6):619-22. [MEDLINE: ] - PubMed
References to studies excluded from this review
AVERROES 2010 {published data only}
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- Alexander W, Connolly S, Arnesen H.European Society of Cardiology: apixaban or aspirin in decreasing stroke risk (The AVERROES Trial) [abstract]. P and T 2010;35(10):580-1. [EMBASE: 359918604]
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- Amin A, Deitelzweig S, Jing Y, Makenbaeva D, Wiederkehr D, Lin J, et al.Comparison of medical costs of patients with atrial fibrillation unsuitable for warfarin treatment with apixaban or aspirin based on AVERROES trial. Clinical & Applied Thrombosis/Hemostasis 2015;21(3):235-40. [MEDLINE: ] - PubMed
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Bang 1994 {published data only}
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- Bang BK, Yang CW, Kim YS, Chang YS, Yoon YS.Effect of combination therapy of captopril and dipyridamole on proteinuria in patients with IgA nephropathy [abstract]. Journal of the American Society of Nephrology 1994;5(3):346. [CENTRAL: CN-00550477]
Caravaca 1995a {published data only}
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- Caravaca F, Lopez-Minguez JR, Arrobas M, Cubero J, Pizarro JL, Cid MC, et al.Haemodynamic changes induced by the correction of anaemia by erythropoietin: role of antiplatelet therapy. Nephrology Dialysis Transplantation 1995;10(9):1720-4. [MEDLINE: ] - PubMed
Changjiang 2015 {published data only}
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- Changjiang H, Jian Q, Yuan Z, Liang Y, Puqing L, Xiaolong G.Tirofiban combined with fondaparinux for post-PCI treatment of patients with acute coronary syndrome and mild renal insufficiency. Cell Biochemistry & Biophysics 2015;73(3):603-7. [MEDLINE: ] - PubMed
Coli 2006 {published data only}
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EXCITE 2000 {published data only}
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- Brugts JJ, Mercado N, Hu S, Guarneri M, Price M, Schatz R, et al.Relation of periprocedural bleeding complications and long-term outcome in patients undergoing percutaneous coronary revascularization (from the Evaluation of Oral Xemilofiban in Controlling Thrombotic Events [EXCITE] Trial). American Journal of Cardiology 2009;103(7):917-22. [MEDLINE: ] - PubMed
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Foroughinia 2017 {published data only}
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- Foroughinia F, Movahed Nouri B, Kojuri J, Ostovan MA.Impact of omega-3 supplementation on high sensitive C-reactive protein level and 30-day major adverse cardiac events after the implementation of coronary stent in patients with chronic kidney disease: a randomized clinical study. Advanced Pharmaceutical Bulletin 2018;8(3):471-8. [MEDLINE: ] - PMC - PubMed
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- Gorter JW.Preventive treatment of patients after non-disabling cerebral ischaemia of presumed arterial origin: Comparative randomized study with intensive anticoagulant therapy or aspirin treatment [Preventieve behandeling van patienten na niet-invaliderende cerebrale ischemie door vermoedelijk arteriele oorzaak: Vergelijkend, gerandomiseerd onderzoek met intensieve antistollingstherapie of behandeling met acetylsalicylzuur]. Nederlands Tijdschrift voor Geneeskunde 1998;142(6):306-12. [EMBASE: 28106209] - PubMed
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POISE‐2 2013 {published data only}
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References to ongoing studies
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- Kim BK.A randomized comparison of CLOpidogrel monotherapy versus extended dual-antiplatelet therapy beyond 12 months after implantation of drug-eluting StEnts in high-risk lesions or patients; A-CLOSE trial. www.cris.nih.go.kr/cris/search/detailSearch.do/18621 (first received 30 April 2019).
ALTIC 2016 {published data only}
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- Alexopoulos D.Low dose ticagrelor versus low dose prasugrel in patients with prior myocardial infarction (ALTIC-2) [A randomized, pharmacodynamic comparison of low dose ticagrelor (60mg Bid) to low dose prasugrel (5mg od) in patients with prior myocardial infarction]. www.clinicaltrials.gov/show/nct03387826 (first received 2 January 2018 ).
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ATTACK 2018 {published data only}40920200
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- Zhao J.Antiplatelet therapy for prevention of atherosclerosis in chronic kidney disease: a perspective, multi-center randomized controlled trial [Antiplatelet prophylaxis for atherosclerosis in chronic kidney disease: a multicenter, randomized, pacebo-controlled trial]. www.chictr.org.cn/showproj.aspx?proj=34865 (first received 18 February 2019).
IRCT2013012412256N1 {published data only}
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- IRCT2013012412256N1.Evaluation the effect of clopidogrel in prevention of access graft thrombosis in upper extrimity in patients undergoing hemodialysis in Emam Reza's Hospital - Kermanshah,2012-2013. www.en.irct.ir/trial/12352 (first received 10 May 2013).
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IRCT20171023036953N1 {published data only}
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LEDA 2017 {published data only}
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- Violi F, Targher G, Vestri A, Carnevale R, Averna M, Farcomeni A, et al.Effect of aspirin on renal disease progression in patients with type 2 diabetes: A multicenter, double-blind, placebo-controlled, randomized trial. The renaL disEase progression by aspirin in diabetic pAtients (LEDA) trial. Rationale and study design. American Heart Journal 2017;189:120-7. [MEDLINE: ] - PubMed
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- Tong PC.The use of cilostazol in patients with diabetic nephropathy [A randomised, double-blind, placebo-controlled study of cilostazol 100 mg twice daily in the treatment of diabetic nephropathy in Hong Kong Chinese]. www.clinicaltrials.gov/show/nct00272831 (first received 9 January 2006).
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NCT01743014 {published data only}
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- Bougatsa VF.Ramipril and clopidogrel in oxidative stress, vascular inflammation and endothelial dysfunction in type 2 diabetes and diabetic nephropathy [A prospective, randomized, two period, with an intermediate wash out period, cross-over study to compare the effects of either combined therapy with ramipril and clopidogrel or ramipril monotherapy on oxidative stress, vascular inflammation and endothelial dysfunction in patients with type 2 diabetes and diabetic nephropathy]. www.clinicaltrials.gov/show/nct01743014 (first received 6 December 2012).
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- Liu PY.Platelet resistance with ticagrelor or standard-dose clopidogrel among CKD and ACS patients (APPROVE-SCKD) [A comParison on Platelet Resistance with ticagrelor or standard-dose clopidogrel study among SeVerE Chronic Kidney Disease/end-stage-renal-disease patients with recent acute coronary syndrome]. www.clinicaltrials.gov/show/nct02459288 (first received 2 June 2015).
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- Nicolau JC.Platelet aggregation in patients with coronary artery disease and kidney dysfunction taking clopidogrel or ticagrelor [Evaluation of platelet aggregation and adenosine levels in patients with coronary artery disease and chronic kidney dysfunction taking dual antiplatelet therapy with aspirin and clopidogrel or ticagrelor]. www.clinicaltrials.gov/show/nct03039205 (first received 1 February 2017).
NCT03150667 {published data only}
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- Nishank J.Chronic kidney disease (CKD) platelet study [A mechanistic study in patients with non-dialysis chronic kidney disease to investigate altered platelet response to antiplatelet therapy (CKD-Platelet study)]. www.clinicaltrials.gov/show/nct03649711 (first received 28 August 2018).
Park 2010 {published data only}
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- Park K, Chung WY, Seo JB, Kim SH, Zo JH, Kim MA, et al.The prevention of contrast induced nephropathy by sarpogrelate in patients with chronic kidney disease: a study protocol for a prospective randomized controlled clinical trial. Trials [Electronic Resource] 2010;11:122. [MEDLINE: ] - PMC - PubMed
PRASTO‐III 2018 {published data only}
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- JapicCTI-184141.PRASTRO-III: a double-blind study of CS-747S versus clopidogrel sulfate in patients with thrombotic stroke having risk factors for stroke recurrence. www.clinicaltrials.jp/cti-user/trial/ShowDirect jsp?japicId=JapicCTI-184141 (first received 25 October 2018).
SERENADE 2015 {published data only}
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- Lee SA, Suh JW, Park JJ, Yoon CH, Cho YS, Youn TJ, et al.Study design of the influence of SErotonin inhibition on patients with RENAl impairment or diabetes undergoing drug-eluting stent implantation (SERENADE) study: A multicenter, open-label, prospective, randomized study. Contemporary Clinical Trials 2015;43:20-4. [MEDLINE: ] - PubMed
SONATA 2013 {published data only}
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- Choi DS.Effect of sarpogrelate on the nephropathy in type 2 diabetes (SONATA study). www.clinicaltrials.gov/show/NCT01869881 (first received June 5 2013).
TROUPER 2020 {published data only}
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VA PTXRx 2018 {published data only}
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