Observational studyPloS one2013
Effects of clopidogrel on mortality, cardiovascular and bleeding outcomes in patients with chronic kidney disease - data from Taiwan acute coronary syndrome full spectrum registry.
Observational study in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Rationale and Study Design of the TSOC-Fully Organized Registry for the Management of Symptomatic ACS Study (T-FORMOSA Study).Acta Cardiologica Sinica · 2023Article
- The Management and Prognostic Factors of Acute Coronary Syndrome: Evidence from the Taiwan Acute Coronary Syndrome Full Spectrum Registry.Acta Cardiologica Sinica · 2017Review
- Renal Function Should be Considered in Determining Superiority of Drug-Eluting Stents over Bare-Metal Stents in Patients with Acute Coronary Syndrome.Acta Cardiologica Sinica · 2016Article
- Diabetes and Adverse Cardiovascular Outcomes in Patients with Acute Coronary Syndrome - Data from Taiwan's Acute Coronary Syndrome Full Spectrum Data Registry.Acta Cardiologica Sinica · 2016Article
- Author Reply to Letter to the Editor: Drug-Eluting Stents versus Bare-Metal Stents in Taiwanese Patients with Acute Coronary Syndrome: An Outcome Report of a Multicenter Registry.Acta Cardiologica Sinica · 2016Article
- Prolonged dual antiplatelet therapy in renal failure: a challenging trade-off.Journal of thoracic disease · 2015Article
Corrections and comments
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Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe efficacy of clopidogrel is inconclusive in the chronic kidney disease (CKD) population with acute coronary syndrome (ACS). Furthermore, CKD patients are prone to bleeding with antiplatelet therapy. We investigated the efficacy and safety of clopidogrel in patients with ACS and CKD.
methodsIn a Taiwan national-wide registry, 2819 ACS patients were enrolled. CKD is defined as an estimated glomerular filtration rate of less than 60 ml/min per 1.73 m(2). The primary endpoints are the combined outcomes of death, non-fatal myocardial infarction and stroke at 12 months.
resultsOverall 949 (33.7%) patients had CKD and 2660 (94.36%) patients received clopidogrel treatment. CKD is associated with increased risk of the primary endpoint at 12 months (HR 2.39, 95% CI 1.82 to 3.15, p<0.01). Clopidogrel use is associated with reduced risk of the primary endpoint at 12 months (HR 0.42, 95% CI: 0.29-0.60, p<0.01). Cox regression analysis showed that clopidogrel reduced death and primary endpoints for CKD population (HR 0.35, 95% CI: 0.21-0.61 and HR 0.48, 95% CI: 0.30-0.77, respectively, both p<0.01). Patients with clopidogrel(-)/CKD(-), clopidogrel(+)/CKD(+) and clopidogrel(-)/CKD(+) have 2.4, 3.0 and 10.4 fold risk to have primary endpoints compared with those receiving clopidogrel treatment without CKD (all p<0.01). Clopidogrel treatment was not associated with increased in-hospital Thrombolysis In Myocardial Infarction (TIMI) bleeding in CKD population.
conclusionClopidogrel could decrease mortality and improve cardiovascular outcomes without increasing risk of bleeding in ACS patients with CKD.
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