Key result
Aspirin and clopidogrel similarly reduce thrombosis in PF4/H antibody-positive hemodialysis patients.
Why the study?
No valid preventive methods for thrombosis in hemodialysis patients with PF4/H antibody positivity have been confirmed.
Do anti-platelet agents like aspirin or clopidogrel reduce the incidence of thrombosis in hemodialysis patients who are PF4/H antibody-positive?
RCT (n=157)
semi-randomized
No
Do anti-platelet agents like aspirin or clopidogrel reduce the incidence of thrombosis in hemodialysis patients who are PF4/H antibody-positive?
Aspirin and clopidogrel effectively reduce the incidence of thrombosis in PF4/H antibody-positive hemodialysis patients, with aspirin being a more cost-effective option.
Answers are grounded in this paper and cite their sources.
Supports antiplatelet therapy in PF4/H-positive hemodialysis patients; extends RCT evidence for aspirin-clopidogrel equivalence in thrombosis prevention.
BACKGROUND: Platelet factor 4/heparin (PF4/H) antibody detection is widely used to evaluate the risk of thrombosis in patients undergoing hemodialysis (HD). Most patients who are PF4/H-antibody-positive can survive thrombosis, but the reason has not been clarified. In addition, no valid preventive methods for thrombosis in patients undergoing HD have been confirmed. METHODS: A single-center, semi-randomized controlled study was designed. In total, 157 patients fulfilled the inclusion criteria and participated. Patients were first divided according to PF4/H antibody detection and then subdivided randomly according to different anti-platelet agent descriptions. RESULTS: (1) PF4/H antibody-positive patients suffered a significantly higher incidence of thrombosis than those who were antibody-negative; (2) PF4/H antibody-positive patients who survived a thrombosis manifested a significantly longer bleeding time and decreased maximum percentage of platelet aggregation inhibition; (3) aspirin and clopidogrel decreased the incidence of thrombosis in PF4/H antibody-positive patients by inhibiting platelet activation. CONCLUSION: The PF4/H antibody was effective for prediction of the risk of thrombosis, except in patients with dysfunctional platelets; aspirin manifested effects similar to clopidogrel in terms of prevention of thromboses in PF4/H antibody-positive patients, but costs much less and is therefore recommended.
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Yang et al. (2014) conducted an RCT in hemodialysis (n=157). Aspirin and clopidogrel vs. Other anti-platelet agent descriptions was evaluated on Incidence of thrombosis.
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