Antiplatelet treatment in patients with end stage renal disease (ESRD) on hemodialysis (HD) is still challenging because of bleeding and thrombotic complications. The investigators hypothesized ticagrelor once daily dose would achieve tolerable antiplatelet effects compared with ticagrelor twice a day dose in ESRD patients on HD.
Chronic kidney disease (CKD) is a strong risk factor for cardiovascular morbidity and mortality, and confers an increasing risk of stent thrombosis even when dual antiplatelet therapy (clopidogrel and aspirin) is administered. Patients with severe CKD or end stage renal disease (ESRD) on hemodialysis (HD) exhibited higher platelet reactivity to clopidogrel than did those with normal renal function. The investigators recently reported platelet inhibition by ticagrelor was faster and markedly greater than by clopidogrel with onset dosing regimen in patients with ESRD on HD. However, few studies have been conducted whether platelet reactivity during ticagrelor treatment is associated with endothelial function, platelet activation markers and inflammation status in ESRD patients on HD. Additionally, the dose dependent effects of ticagrelor have been rarely evaluated.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
25
After randomization, each group will be treated as assigned dose of ticagrelor (ticagrelor 90mg once a day or 90mg twice a day) for 14 days. After 1 week wash-out period, cross-over study will be performed
Kyung Hee University Hospital
Seoul, Seoul, South Korea
RECRUITINGThe difference of antiplatelet effects assessed by VerifyNow assay
The difference of PRU values achieved following antiplatelet therapy
Time frame: 14 days after study drug treatment
The difference of antiplatelet effects assessed by light aggregometry assay
The difference of IPA values achieved following antiplatelet therapy
Time frame: 14 days after study drug treatment
The difference of endothelial function assessed by forearm flow-mediated vasodilation (FMD) and peripheral arterial tonometry (PAT)
The difference of endothelial functions achieved following antiplatelet therapy
Time frame: 14 days after study drug treatment
The difference of anti-inflammatory biomarkers
The difference of hsCRP, CD40, P-selectin, and IL-6
Time frame: 14 days after study drug treatment
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