Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn people with chronic kidney disease, antiplatelet drugs reduce heart attacks but increase bleeding
Palmer SC, Di Micco L, Razavian M, et al. Antiplatelet agents for chronic kidney disease. Cochrane Database Syst Rev. 2013;2:CD008834.
Review question
What are the effects of antiplatelet drugs in people with chronic kidney disease?
Background
Chronic kidney disease is a progressive loss in kidney function over a period of months or years.
Cardiovascular disease refers to diseases that involve the heart and the system of arteries that carry blood to the body. These diseases include stroke and heart attack. Cardiovascular disease is the leading cause of sickness and death in people with chronic kidney disease.
Platelets are blood clot cells. Clots may result in stroke and heart attacks. Antiplatelet drugs prevent clot formation.
Antiplatelet drugs might be beneficial in patients with chronic kidney disease to prevent stroke and heart attacks.
How the review was done
This summary is based on a systematic review of 50 randomized controlled trials involving 27,139 people. Period of publication was 1974 to 2010.
Outcomes included heart attacks, strokes, death from all causes, death from cardiovascular disease, major and minor bleeding, kidney disease, kidney transplant failure, and dialysis.
What the researchers found
Antiplatelet drugs compared with placebo or no treatment
- Antiplatelet drugs reduced the risk of heart attacks by 13%.
- Antiplatelet drugs did not reduce death from any cause, death from stroke, or cardiovascular-related death.
- Antiplatelet drugs increased the risk of major bleeding by 33% and minor bleeding by 48%.
- For all types of dialysis access, antiplatelet drugs reduced failure of the access site by 32%.
- Antiplatelet drugs did not differ in the relative benefits or harms of treatment by drug type (aspirin, ticlopidine, or clopidogrel) or by stage of chronic kidney disease.
Comparisons among antiplatelet drugs
- Data for direct comparisons of 1 antiplatelet drug with another were limited.
Conclusion
Antiplatelet drugs (for about 12 months) lower the risk of heart attacks in people with chronic kidney disease.
Antiplatelet drugs increase major and minor bleeding.
Antiplatelet drugs (aspirin, ticlopidine, or clopidrogrel) vs placebo or no treatment in people with chronic kidney disease
| Outcomes | Results with antiplatelet drugs |
| Heart attack | 13% decrease |
| Death (from any cause, stroke, or related to cardiovascular disease) | No difference |
| Major bleeding | 33% increase |
| Minor bleeding | 48% increase |
| Failure of dialysis access site | 32% decrease |
Related Topics
Glossary
A harmless, inactive, and simulated treatment.
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.
Related Evidence Summaries
-
Educational and behavioural interventions for anticoagulant therapy in patients with atrial fibrillation
Cochrane Database of Systematic Reviews (2017) -
Providing patients and their care providers with information about cardiovascular disease risk may help with prevention measures
BMJ Open (2015) -
Dietary fibre for the primary prevention of cardiovascular disease
Cochrane Database of Systematic Reviews (2016)
Related Web Resources
-
High cholesterol: Does reducing the amount of fat in your diet help?
Informed Health OnlineEat less saturated fats in your diet to help prevent heart disease. Eat less meat, butter, cheese and cream to improve your health long-term. -
Statins: Should I Take Them to Prevent a Heart Attack or Stroke?
OHRIThis patient decision aid helps people considering taking medicines called statins to lower their risk of heart attack and stroke by comparing the benefits, risks, and side effects of both options. It also includes alternative treatment options to taking statins such as trying to lower risk with lifestyle changes. -
Heart Disease: Should I Have Angioplasty for Stable Angina?
OHRIThis patient decision aid helps adults with mild heart disease or stable angina decide on whether to have angioplasty or only take medicines and make lifestyle changes by comparing the benefits, risks, and side effects of both options.
Register for free access to all Professional content
RegisterOur Content
About
Support for the Portal is largely provided by the Labarge Optimal Aging Initiative. AGE-WELL is a contributing partner. Help us to continue to provide direct and easy access to evidence-based information on health and social conditions to help you stay healthy, active and engaged as you grow older. Donate Today.
