Differences in Whole Blood Platelet Aggregation at Baseline and in Response to Aspirin and Aspirin Plus Clopidogrel in Patients With Versus Without Chronic Kidney Disease

Thrombotic events while receiving antiplatelet agents (APAs) are more common in subjects with versus without chronic kidney disease (CKD). Data on antiplatelet effects of APA in CKD are scarce and limited by lack of baseline platelet function before APA treatment. We hypothesized subjects with stage...

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Bibliographic Details
Published in:The American journal of cardiology 2016-02, Vol.117 (4), p.656-663
Main Authors: Jain, Nishank, MD, MPH, Li, Xilong, PhD, Adams-Huet, Beverley, MS, Sarode, Ravi, MD, Toto, Robert D., MD, Banerjee, Subhash, MD, Hedayati, S. Susan, MD, MHSc
Format: Article
Language:English
Subjects:
Acids
Adenosine
Aspirin
Aspirin - administration & dosage
Blood
Blood platelets
Cardiovascular
Collagen
Cytochrome
Diabetes
Dose-Response Relationship, Drug
Drug Therapy, Combination
Female
Follow-Up Studies
Genotype & phenotype
Humans
Kidney diseases
Male
Metabolism
Metabolites
Middle Aged
Platelet Aggregation - drug effects
Platelet Aggregation Inhibitors - administration & dosage
Platelet Function Tests
Prospective Studies
Renal Insufficiency, Chronic - blood
Renal Insufficiency, Chronic - complications
Thrombosis - blood
Thrombosis - complications
Thrombosis - prevention & control
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
Treatment Outcome
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Description
Summary:Thrombotic events while receiving antiplatelet agents (APAs) are more common in subjects with versus without chronic kidney disease (CKD). Data on antiplatelet effects of APA in CKD are scarce and limited by lack of baseline platelet function before APA treatment. We hypothesized subjects with stages 4 to 5 CKD versus no CKD have greater baseline platelet aggregability and respond poorly to aspirin and clopidogrel. In a prospective controlled study, we measured whole blood platelet aggregation (WBPA) in 28 CKD and 16 non-CKD asymptomatic stable outpatients not on APA, frequency-matched for age, gender, obesity, and diabetes mellitus. WBPA was remeasured after 2 weeks of each aspirin and aspirin plus clopidogrel. The primary outcome was percent inhibition of platelet aggregation (IPA) from baseline. The secondary outcome was residual platelet aggregability (RPA; proportion with
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2015.11.029