Effect of Haemodialysis on the Efficacy of Antiplatelet Agents

The First Affiliated Hospital with Nanjing Medical University60 enrolled

Overview

The main purpose of our study is to investigate whether haemodialysis itself affects the efficacy of antiplatelet drugs and the effects of two different types of dialysis membranes (polysulfone membranes and polyamide membranes) on antiplatelet efficacy. A total of 60 patients with ESRD and under dual-antiplatelet treatmen for at least 5 days will be enrolled and divided into the Clopidogrel group (clopidogrel 75mg qd;aspirin 100mg qd, n=30) and the Ticagrelor group (ticagrelor 90mg bid; aspirin 100mg qd, n=30). All included patients will receive haemodialysis by two different types of dialysis membrane.Platelet aggregation of venous blood from all patients will be detected by LTA and VerifyNow immediately before and after two times of haemodialysis.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Renal Failure Coronary Artery Disease Hemolysis

Interventions

Clopidogrel group;Ticagrelor group

A total of 60 patients with ESRD and under dual-antiplatelet treatmen for at least 5 days will be enrolled and divided into the Clopidogrel group (clopidogrel 75mg qd;aspirin 100mg qd, n=30) and the Ticagrelor group (ticagrelor 90mg bid; aspirin 100mg qd, n=30). All included patients will receive haemodialysis by two different types of dialysis membrane.Platelet aggregation of venous blood from all patients will be detected by LTA and VerifyNow immediately before and after haemodialysis.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * diagnosis of coronary heart disease including stable angina, unstable angina, acute myocardial infarction * taking dual antiplatelet drugs (clopidogrel 75mg qd + aspirin 100mg qd or ticagrelor 90 mg,bid + aspirin 100 mg,qd) at least 5 days * haemodialysis patients * sign informed consent Exclusion Criteria: * platelet count\>450 × 10 9 /L or \<100 × 10 9 /L * using IIb / IIIa inhibitor drugs within 10days * taking nonsteroidal anti-inflammatory drugs other than aspirin * hemorrhagic disease * allergic to aspirin, ticagrelor or clopidogrel * other factors may affect the results of this study

Outcomes

Primary Outcomes

using light transmittance aggregometer to detect whether haemodialysis can affect the efficacy of antiplatelet agents

intravenous blood collection with anticoagulant tube before and after haemodialysis respectively ；using light transmittance aggregometer to detect adenosine diphosphate induced platelet aggregation rate and arachidonic acid induced platelet aggregation rate within two hours after blood collection;;compare the outcome of light transmittance aggregometer with VerifyNow

Time frame: collecting blood within 10 miuntes before and after haemodialysis;detecting them within 2 hours

Secondary Outcomes

using VerifyNow to detect whether haemodialysis can affect the efficacy of antiplatelet agents

intravenous blood collection with VeryfiNow to detect the platelet reaction unit before and after haemodialysis respectively