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Chronic kidney disease and risk for cardiovascular and limb outcomes in patients with symptomatic peripheral artery disease: The EUCLID trial.
Hopley, Charles W; Kavanagh, Sarah; Patel, Manesh R; Ostrom, Cara; Baumgartner, Iris; Berger, Jeffrey S; Blomster, Juuso I; Fowkes, F Gerry R; Jones, W Schuyler; Katona, Brian G; Mahaffey, Kenneth W; Norgren, Lars; Rockhold, Frank W; Hiatt, William R.
Afiliação
  • Hopley CW; Department of Medicine, Section of Nephrology and Hypertension, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Hanover, NH, USA.
  • Kavanagh S; CPC Clinical Research, Aurora, CO, USA.
  • Patel MR; CPC Clinical Research, Aurora, CO, USA.
  • Ostrom C; Duke Clinical Research Institute, Durham, NC, USA.
  • Baumgartner I; Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.
  • Berger JS; CPC Clinical Research, Aurora, CO, USA.
  • Blomster JI; Swiss Cardiovascular Centre, Inselspital, Division of Angiology, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Fowkes FGR; Departments of Medicine and Surgery, New York University School of Medicine, New York, NY, USA.
  • Jones WS; Turku University Hospital, University of Turku, Turku, Finland.
  • Katona BG; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
  • Mahaffey KW; Duke Clinical Research Institute, Durham, NC, USA.
  • Norgren L; Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC, USA.
  • Rockhold FW; AstraZeneca Gaithersburg, Gaithersburg, MD, USA.
  • Hiatt WR; Stanford Center for Clinical Research, Stanford University School of Medicine, Stanford, CA, USA.
Vasc Med ; 24(5): 422-430, 2019 10.
Article em En | MEDLINE | ID: mdl-31339474
In patients with symptomatic peripheral artery disease (PAD), the impact of chronic kidney disease (CKD) on major adverse cardiovascular events has not been fully evaluated. The Examining Use of Ticagrelor In PAD (EUCLID) trial randomized 13,885 patients with PAD to ticagrelor 90 mg twice daily or clopidogrel 75 mg daily. This post hoc analysis compared the incidence of the primary composite endpoint (cardiovascular death, myocardial infarction (MI), or ischemic stroke) in patients with CKD (eGFR < 60 mL/min/1.73 m2) with those without CKD (eGFR ⩾ 60 mL/min/1.73 m2). The primary safety endpoint was thrombolysis in MI (TIMI) major bleeding. A total of 13,483 patients were included; 3332 (25%) had CKD, of whom 237 had stage 4/5 disease. Median follow-up was approximately 30 months. After statistical adjustment, patients with CKD had a higher rate of the primary endpoint compared with those without CKD (6.75 vs 3.72 events/100 patient-years; adjusted hazard ratio (HR) 1.45, 95% CI 1.30-1.63). CKD was not associated with increased risk of hospitalization for acute limb ischemia (ALI) (adjusted HR 0.96, 95% CI 0.69-1.34) or major amputation (adjusted HR 0.92, 95% CI 0.66-1.28). CKD was not associated with a significantly increased risk of major bleeding (adjusted HR 1.21, 95% CI 0.89-1.64), but minor bleeding was significantly increased (adjusted HR 1.51, 95% CI 1.07-2.15). In conclusion, patients with PAD and CKD had higher rates of cardiovascular death, MI, and ischemic stroke, but similar rates of ALI, major amputation, and TIMI major bleeding when compared with patients without CKD. ClinicalTrials.gov Identifier: NCT01732822.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Insuficiência Renal Crônica / Doença Arterial Periférica / Clopidogrel / Ticagrelor / Taxa de Filtração Glomerular / Isquemia / Rim Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged80 Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Inibidores da Agregação Plaquetária / Insuficiência Renal Crônica / Doença Arterial Periférica / Clopidogrel / Ticagrelor / Taxa de Filtração Glomerular / Isquemia / Rim Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Incidence_studies / Prognostic_studies / Risk_factors_studies Limite: Aged80 Idioma: En Ano de publicação: 2019 Tipo de documento: Article