Prasugrel Versus High Dose Clopidogrel in Clopidogrel Resistant Patients Undergoing Chronic Hemodialysis

Inclusion Criteria: 1. Age ≥18 years old 2. History of chronic renal failure under hemodialysis for at least 6 months 3. Under clopidogrel 75mg/day treatment for at least 7 days before randomization 4. Informed consent obtained in writing Exclusion Criteria: 1. Treatment with other investigational agents (including placebo) or devices within 30 days prior to randomization or planned use of investigational agents or devices prior to the Day 30 visit. 2. Pregnancy 3. Breastfeeding 4. Inability to give informed consent or high likelihood of being unavailable for the Day 30 follow up. 5. Malignancy 6. Acute coronary syndrome or hemodynamic instability within 30 days prior to randomization 7. Requirement for oral anticoagulant prior to the Day 30 visit 8. Requirement for discontinuation of thienopyridine treatment prior to the Day 30 visit 9. Treatment with IIb/IIIa inhibitors within 30 days prior to randomization or planned administration prior to the Day 30 visit 10. Known hypersensitivity to prasugrel or clopidogrel. 11. History of gastrointestinal bleeding, genitourinary bleeding or other site abnormal bleeding within the previous 6 months. 12. Other bleeding diathesis, or considered by investigator to be at high risk for bleeding on thienopyridine therapy. 13. Any previous history of ischemic stroke, intracranial hemorrhage or disease (neoplasm, arteriovenous malformation, aneurysm). 14. Thrombocytopenia (\<100.000 / μL) at randomization 15. Known liver failure (bilirubin \> 2mg/dl)