Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients

Takeshi Nishi, Noritaka Ariyoshi, Takashi Nakayama, Yoshihide Fujimoto, Kazumasa Sugimoto, Shinichi Wakabayashi, Hideki Hanaoka, Yoshio Kobayashi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background The impact of chronic kidney disease (CKD) on the antiplatelet effect of clopidogrel and low-dose (3.75 mg) prasugrel in Japanese patients is largely unknown. Methods A total of 53 consecutive Japanese patients with stable coronary artery disease who received aspirin and clopidogrel were enrolled, and categorized by estimated glomerular filtration rate (eGFR): CKD group (n = 15, eGFR < 60 ml/min/1.73 m2) and non-CKD group (n = 38, eGFR ≥ 60 ml/min/1.73 m2). Clopidogrel was switched to 3.75 mg prasugrel. Platelet reactivity measurement using the VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA) was performed at baseline (on clopidogrel) and day 14 (on prasugrel). Results The VerifyNow P2Y12 reaction units (PRU) during clopidogrel therapy was significantly higher in the CKD group than that in the non-CKD group (185.2 ± 51.1 PRU vs. 224.3 ± 57.0 PRU, p = 0.02), whereas, the PRU with the prasugrel therapy in the CKD group and non-CKD group were not significantly different (149.9 ± 51.1 PRU vs. 165.3 ± 61.8 PRU, p = 0.36). The PRU was significantly lower with the prasugrel therapy compared to that with the clopidogrel therapy both in the CKD group and in the non-CKD group. Conclusions Antiplatelet effect of clopidogrel but not prasugrel is attenuated in patients with CKD. Prasugrel achieves a consistently lower platelet reactivity compared with clopidogrel regardless of the presence of mild to moderate CKD.

Original languageEnglish
Pages (from-to)752-755
Number of pages4
JournalJournal of Cardiology
Volume69
Issue number5
DOIs
Publication statusPublished - May 1 2017
Externally publishedYes

Fingerprint

clopidogrel
Chronic Renal Insufficiency
Blood Platelets
Kidney Diseases
Glomerular Filtration Rate
Prasugrel Hydrochloride
Therapeutics
Aspirin

Keywords

  • Chronic kidney disease
  • Clopidogrel
  • Platelet reactivity
  • Prasugrel

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients. / Nishi, Takeshi; Ariyoshi, Noritaka; Nakayama, Takashi; Fujimoto, Yoshihide; Sugimoto, Kazumasa; Wakabayashi, Shinichi; Hanaoka, Hideki; Kobayashi, Yoshio.

In: Journal of Cardiology, Vol. 69, No. 5, 01.05.2017, p. 752-755.

Research output: Contribution to journalArticle

Nishi, T, Ariyoshi, N, Nakayama, T, Fujimoto, Y, Sugimoto, K, Wakabayashi, S, Hanaoka, H & Kobayashi, Y 2017, 'Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients', Journal of Cardiology, vol. 69, no. 5, pp. 752-755. https://doi.org/10.1016/j.jjcc.2016.07.017
Nishi, Takeshi ; Ariyoshi, Noritaka ; Nakayama, Takashi ; Fujimoto, Yoshihide ; Sugimoto, Kazumasa ; Wakabayashi, Shinichi ; Hanaoka, Hideki ; Kobayashi, Yoshio. / Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients. In: Journal of Cardiology. 2017 ; Vol. 69, No. 5. pp. 752-755.
@article{a8b59947d79d4778bf6aacb1242e1570,
title = "Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients",
abstract = "Background The impact of chronic kidney disease (CKD) on the antiplatelet effect of clopidogrel and low-dose (3.75 mg) prasugrel in Japanese patients is largely unknown. Methods A total of 53 consecutive Japanese patients with stable coronary artery disease who received aspirin and clopidogrel were enrolled, and categorized by estimated glomerular filtration rate (eGFR): CKD group (n = 15, eGFR < 60 ml/min/1.73 m2) and non-CKD group (n = 38, eGFR ≥ 60 ml/min/1.73 m2). Clopidogrel was switched to 3.75 mg prasugrel. Platelet reactivity measurement using the VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA) was performed at baseline (on clopidogrel) and day 14 (on prasugrel). Results The VerifyNow P2Y12 reaction units (PRU) during clopidogrel therapy was significantly higher in the CKD group than that in the non-CKD group (185.2 ± 51.1 PRU vs. 224.3 ± 57.0 PRU, p = 0.02), whereas, the PRU with the prasugrel therapy in the CKD group and non-CKD group were not significantly different (149.9 ± 51.1 PRU vs. 165.3 ± 61.8 PRU, p = 0.36). The PRU was significantly lower with the prasugrel therapy compared to that with the clopidogrel therapy both in the CKD group and in the non-CKD group. Conclusions Antiplatelet effect of clopidogrel but not prasugrel is attenuated in patients with CKD. Prasugrel achieves a consistently lower platelet reactivity compared with clopidogrel regardless of the presence of mild to moderate CKD.",
keywords = "Chronic kidney disease, Clopidogrel, Platelet reactivity, Prasugrel",
author = "Takeshi Nishi and Noritaka Ariyoshi and Takashi Nakayama and Yoshihide Fujimoto and Kazumasa Sugimoto and Shinichi Wakabayashi and Hideki Hanaoka and Yoshio Kobayashi",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.jjcc.2016.07.017",
language = "English",
volume = "69",
pages = "752--755",
journal = "Journal of cardiography. Supplement",
issn = "0914-5087",
publisher = "Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)",
number = "5",

}

TY - JOUR

T1 - Impact of chronic kidney disease on platelet inhibition of clopidogrel and prasugrel in Japanese patients

AU - Nishi, Takeshi

AU - Ariyoshi, Noritaka

AU - Nakayama, Takashi

AU - Fujimoto, Yoshihide

AU - Sugimoto, Kazumasa

AU - Wakabayashi, Shinichi

AU - Hanaoka, Hideki

AU - Kobayashi, Yoshio

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background The impact of chronic kidney disease (CKD) on the antiplatelet effect of clopidogrel and low-dose (3.75 mg) prasugrel in Japanese patients is largely unknown. Methods A total of 53 consecutive Japanese patients with stable coronary artery disease who received aspirin and clopidogrel were enrolled, and categorized by estimated glomerular filtration rate (eGFR): CKD group (n = 15, eGFR < 60 ml/min/1.73 m2) and non-CKD group (n = 38, eGFR ≥ 60 ml/min/1.73 m2). Clopidogrel was switched to 3.75 mg prasugrel. Platelet reactivity measurement using the VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA) was performed at baseline (on clopidogrel) and day 14 (on prasugrel). Results The VerifyNow P2Y12 reaction units (PRU) during clopidogrel therapy was significantly higher in the CKD group than that in the non-CKD group (185.2 ± 51.1 PRU vs. 224.3 ± 57.0 PRU, p = 0.02), whereas, the PRU with the prasugrel therapy in the CKD group and non-CKD group were not significantly different (149.9 ± 51.1 PRU vs. 165.3 ± 61.8 PRU, p = 0.36). The PRU was significantly lower with the prasugrel therapy compared to that with the clopidogrel therapy both in the CKD group and in the non-CKD group. Conclusions Antiplatelet effect of clopidogrel but not prasugrel is attenuated in patients with CKD. Prasugrel achieves a consistently lower platelet reactivity compared with clopidogrel regardless of the presence of mild to moderate CKD.

AB - Background The impact of chronic kidney disease (CKD) on the antiplatelet effect of clopidogrel and low-dose (3.75 mg) prasugrel in Japanese patients is largely unknown. Methods A total of 53 consecutive Japanese patients with stable coronary artery disease who received aspirin and clopidogrel were enrolled, and categorized by estimated glomerular filtration rate (eGFR): CKD group (n = 15, eGFR < 60 ml/min/1.73 m2) and non-CKD group (n = 38, eGFR ≥ 60 ml/min/1.73 m2). Clopidogrel was switched to 3.75 mg prasugrel. Platelet reactivity measurement using the VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA) was performed at baseline (on clopidogrel) and day 14 (on prasugrel). Results The VerifyNow P2Y12 reaction units (PRU) during clopidogrel therapy was significantly higher in the CKD group than that in the non-CKD group (185.2 ± 51.1 PRU vs. 224.3 ± 57.0 PRU, p = 0.02), whereas, the PRU with the prasugrel therapy in the CKD group and non-CKD group were not significantly different (149.9 ± 51.1 PRU vs. 165.3 ± 61.8 PRU, p = 0.36). The PRU was significantly lower with the prasugrel therapy compared to that with the clopidogrel therapy both in the CKD group and in the non-CKD group. Conclusions Antiplatelet effect of clopidogrel but not prasugrel is attenuated in patients with CKD. Prasugrel achieves a consistently lower platelet reactivity compared with clopidogrel regardless of the presence of mild to moderate CKD.

KW - Chronic kidney disease

KW - Clopidogrel

KW - Platelet reactivity

KW - Prasugrel

UR - http://www.scopus.com/inward/record.url?scp=84994097469&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994097469&partnerID=8YFLogxK

U2 - 10.1016/j.jjcc.2016.07.017

DO - 10.1016/j.jjcc.2016.07.017

M3 - Article

C2 - 27567173

AN - SCOPUS:84994097469

VL - 69

SP - 752

EP - 755

JO - Journal of cardiography. Supplement

JF - Journal of cardiography. Supplement

SN - 0914-5087

IS - 5

ER -