Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Youyi Road No.1, Yuzhong District, Chongqing, 400016, China.
Department of Anesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Gusao Road No. 16, Jianghan District, Wuhan, 430014, Hubei, China.
BMC Nephrol. 2018 Dec 27;19(1):376. doi: 10.1186/s12882-018-1166-0.
To assess the time to first on-study vascular thromboembolic events (VTEs) of clopidogrel (CL) or beraprost sodium (BPS) in Chinese population with end-stage renal disease (ESRD) treated with arteriovenous fistula (AVF) surgery.
From Jan 2009 to May 2015, 346 ESRD cases suffering an AVF surgery and undergoing oral administration of 75 mg CL (initial dose of 300 mg), 1 time/day, for 4 weeks or 40 μg BPS, 3 times/day, for 4 weeks were retrospectively assessed. The primary outcome was time to first on-study VTE.
In total, 222 ESRD cases (CL, n = 112; BPS, n = 110) were assessed, with a median follow-up time of 38.1 months (range, 37-40 months). The mean time to first on-study VTE was 1.2 weeks (0.5-2.3) and 1.8 weeks (1.2-3.8) for CL and BPS, respectively (HR 0.27, 95% CI 0.16-1.45; P = 0.00). An increased incidence of VTEs was found during the 1th-month follow-up, with rates of 14.2 and 5.5% for CL and BPS, respectively (P = 0.03). The difference persisted over time, with rates of 24.1 and 11.8% at final follow-up, respectively (P = 0.02).
CL with an increased risk of VTEs tended to have a VTE within the 1st month after cessation compared with BPS.
评估中国终末期肾病（ESRD）患者经动静脉瘘（AVF）手术后使用氯吡格雷（CL）或贝前列素钠（BPS）的首次研究期间血管血栓栓塞事件（VTE）的时间。
2009 年 1 月至 2015 年 5 月，回顾性评估了 346 例接受 AVF 手术并口服 75mg CL（初始剂量 300mg），1 次/天，持续 4 周或 40μg BPS，3 次/天，持续 4 周的 ESRD 病例。主要结局是首次研究期间 VTE 的时间。
共评估了 222 例 ESRD 病例（CL，n=112；BPS，n=110），中位随访时间为 38.1 个月（范围，37-40 个月）。CL 和 BPS 首次研究期间 VTE 的平均时间分别为 1.2 周（0.5-2.3 周）和 1.8 周（1.2-3.8 周）（HR 0.27，95%CI 0.16-1.45；P=0.00）。在第 1 个月的随访中发现 VTE 发生率增加，CL 和 BPS 的发生率分别为 14.2%和 5.5%（P=0.03）。随着时间的推移，这种差异持续存在，最终随访时的发生率分别为 24.1%和 11.8%（P=0.02）。
与 BPS 相比，CL 停药后 1 个月内 VTE 风险增加，VTE 倾向于发生。
