期刊
PLATELETS
卷 34, 期 1, 页码 -出版社
TAYLOR & FRANCIS INC
DOI: 10.1080/09537104.2022.2154330
关键词
Acute coronary syndrome (ACS); antiplatelet; cardiovascular disease; chronic kidney disease (CKD); end stage kidney disease (ESKD); ischaemic heart disease (IHD); P2Y(12) inhibitor; renal replacement therapy (RRT)
Chronic kidney disease is a global health problem and is associated with cardiovascular morbidity and mortality. However, the effectiveness and safety of antiplatelet therapy in patients with end-stage kidney disease are still uncertain. Therefore, more research is needed to understand the treatment options in this population.
Chronic kidney disease (CKD) is a global health problem and an independent risk factor for cardiovascular morbidity and mortality. Despite evidence-based therapies significantly improving cardiovascular mortality outcomes in the general population and those with non-dialysis dependent CKD, this risk reduction has not translated to patients with end-stage kidney disease (ESKD). Absent from all major antiplatelet trials, this has led to insufficient safety data for P2Y12 inhibitor prescriptions and treatment inequity in this subpopulation. This review article presents an overview of the progression of research in understanding antiplatelet therapy for ischaemic heart disease in patients with advanced CKD (defined as eGFR < 30 mL/min/1.73 m2). Beyond trial recruitment strategies, new approaches should focus on registry documentation by CKD stage, risk stratification with biomarkers associated with inflammation and haemorrhage and building a knowledge base on optimal duration of dual and single antiplatelet therapies.
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