Premium
Oral P2Y 12 Receptor Inhibitors in Hemodialysis Patients Undergoing Percutaneous Coronary Interventions: Current Knowledge and Future Directions
Author(s) -
Jain Nishank,
Reilly Robert F.
Publication year - 2016
Publication title -
seminars in dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 78
eISSN - 1525-139X
pISSN - 0894-0959
DOI - 10.1111/sdi.12484
Subject(s) - medicine , prasugrel , clopidogrel , ticagrelor , percutaneous coronary intervention , conventional pci , acute coronary syndrome , coronary artery disease , intensive care medicine , hemodialysis , cardiology , population , myocardial infarction , environmental health
Abstract Oral P2Y 12 receptor inhibitors are commonly used drugs in patients on hemodialysis (HD) to treat acute coronary syndrome with or without percutaneous coronary intervention (PCI), and patients with stable coronary artery disease after PCI. Clopidogrel is the most commonly prescribed P2Y 12 receptor inhibitor because it is effective in the general population and is not as costly as newer FDA‐approved agents (prasugrel, ticagrelor). However, increasing evidence is accumulating that clopidogrel may not be as effective in reducing mortality and preventing future ischemic events in patients with kidney disease. In this review, we will explore some of the studies that form the basis for this statement and discuss potential pharmacokinetic and pharmacodynamic reasons why clopidogrel might be less effective in HD patients, as well as explore potential risks and benefits of alternatives to clopidogrel therapy.