title: Inhibition of platelet activation could decrease thrombotic events in hemodialysis PF4/H antibody-positive patients.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Therapeutic Centre of Kidney Diseases, First Affiliated Hospital of Beidaihe Sanatorium of Beijing Military Region , Qinhuangdao, Hebei Province , P.R. China .
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Deyang
authors.initials: D
authors.lastname: Kong
authors.forename: Chao
authors.initials: C
authors.lastname: Wang
authors.forename: Guanglei
authors.initials: G
authors.lastname: Chen
authors.forename: Fujun
authors.initials: F
authors.lastname: Shan
authors.forename: Ka
authors.initials: K
authors.lastname: Qi
authors.forename: Lu
authors.initials: L
authors.lastname: Ma
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D000077144:Clopidogrel; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D010978:Platelet Factor 4 / Q000276:immunology*; D006435:Renal Dialysis / Q000009:adverse effects*; D013927:Thrombosis / Q000453:epidemiology / Q000276:immunology* / Q000517:prevention & control; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D010978:Platelet Factor 4; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Anti-platelet; PF4/H antibodies; heparin-induced thrombocytopenia; platelet dysfunction; thrombosis