title: Oral P2Y12 Receptor Inhibitors in Hemodialysis Patients Undergoing Percutaneous Coronary Interventions: Current Knowledge and Future Directions.
abstract: Oral P2Y12 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 P2Y12 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.
authors.affiliation: Kidney Institute, University of Kansas Medical Center, Kansas City, Kansas.
authors.forename: Nishank
authors.initials: N
authors.lastname: Jain
authors.affiliation: Division of Nephrology, Medical Service, Veterans Affairs North Texas Health Care System, Dallas, Texas. robert.reilly2@va.gov.|Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas. robert.reilly2@va.gov.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Reilly
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000241:Adenosine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000077144:Clopidogrel; D006801:Humans; D062645:Percutaneous Coronary Intervention; D000068799:Prasugrel Hydrochloride / Q000627:therapeutic use; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D006435:Renal Dialysis; D000077486:Ticagrelor; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D000077486:Ticagrelor; D000241:Adenosine; D013988:Ticlopidine