antiplatelet therapy in hemodialysis patients undergoing percutaneous coronary interventions

نویسندگان

francesco summaria department of cardiology-policlinico casilino, catheter laboratory, rome, italy; department of cardiology-policlinico casilino, catheter laboratory, rome, italy. tel: +39-0623188448

maria b. giannico department of cardiology-policlinico casilino, catheter laboratory, rome, italy

giovanni p. talarico department of cardiology-policlinico casilino, catheter laboratory, rome, italy

roberto patrizi department of cardiology-policlinico casilino, catheter laboratory, rome, italy

چکیده

conclusions this investigation might contribute to delineate the best treatment options for this high risk population. evidence acquisition we reviewed current evidences on the use of antiplatelet therapy in patients with esrd/hd undergoing pci, focusing on the efficacy and safety of specific agents and their indications for detailed clinical settings. results clinical setting in hd patients is the principal determinant of the type, onset, combination and duration of the dapt. however, irrespective clinical setting, in addition to aspirin, clopidogrel is currently the most used antiplatelet agent even if no information derived from rcts are available in esrd. due to the large experience acquired in routine clinical practice, the awareness of safety is higher for clopidogrel than newer antiplatelet agents. because of lack of data, the use of prasugrel and ticagrelor is actually not recommended. however, in case of high ischemic and acceptable bleeding risk, they may be selectively used in esrd/hd. context coronary artery disease is highly prevalent among patients with end stage renal disease/hemodialysis (esrd/hd) and coronary percutaneous interventions (pci) has been increased by nearly 50% over the past decade. after pci with stent placement, guidelines recommend dual antiplatelet therapy (dapt), but no specifically tailored pharmacotherapy approach is outlined for this frail population, mostly excluded from large randomized clinical trials (rcts).

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Antiplatelet Therapy in Hemodialysis Patients Undergoing Percutaneous Coronary Interventions

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عنوان ژورنال:
nephro-urology monthly

جلد ۷، شماره ۴، صفحات ۰-۰

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