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CKD may influence the response to antiplatelet therapy. We, therefore, sought to investigate its effect on platelet inhibition according to its stages.
We assessed platelet inhibition (PI) among those patients on dual antiplatelet regimen (75 mg of Aspirin and 75 mg of clopidogrel) in various stages of CKD in 922 patients after PCI with stent implantation. Platelet inhibition was tested with platelet aggregometry. Effective PI is defined as > 50% platelet inhibition. CKD was defined as a estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 . eGFR was estimated by MDRD formula. We analyzed PI levels with eGFR values using Pearson correlation test.
Total no of cases are 922. Male:female::3.4:1. 606 (66%) were hypertensives, 417 (45%) were diabetics and 224 (24%) were smokers. 548 (59%) pts were presented with ACS and multi vessel angioplasty was done in 214 (23%) patients. Total no of lesions treated were 1225 in 922 pts . Prevalence of patients according to stages of CKD were - Stage 1 - 209(23%); Stage 2 - 415 45(%);Stage 3a - 158 (17%); Stage 3b - 104 (11%); Stage 4 - 15 (1.6%); Stage 5 - 19(2%) pts. There was no correlation between estimated GFR and percentage of inhibition of platelets in all pts (Pearson correlation = -0.021; p Value = 0.7) and in different stages CKD pts (Stage 1 - Pearson correlation = -0.039, p value = 0.8, Stage 2 - correlation = -0.008, p = 0.9, Stage 3a correlation = -0.002, p = 0.98, Stage 3b correlation = 0.052, p = 0.8, Stage 4 correlation = 0.9, p = 0.1 and Stage 5 correlation = -0.6, p = 0.3) .
Presence of CKD (including the all stages) does not influence the effectiveness of platelet inhibition with antiplatelet therapy in pts undergoing PCI for obstructive CAD.