PMID- 28922656
OWN - NLM
STAT- MEDLINE
DCOM- 20180625
LR  - 20180625
IS  - 1423-0143 (Electronic)
IS  - 1420-4096 (Linking)
VI  - 42
IP  - 3
DP  - 2017
TI  - Impact of the Number of Anti-Thrombosis Agents in Hemodialysis Patients: 
      BOREAS-HD2 Study.
PG  - 553-564
LID - 10.1159/000480487 [doi]
AB  - BACKGROUND/AIMS: Relationships between the number of anti-thrombosis agents, 
      clinical benefits and adverse events in hemodialysis (HD) patients are unclear. 
      METHODS: All patients on HD in 22 institutes (n = 1,071) were enrolled and 
      followed up for 3 years. After exclusion of patients with missing data, kidney 
      transplantation or retraction of consent during the follow-up period (n = 204), 
      mortality rate and ischemic and hemorrhagic events were compared between 
      different regimens of anti-thrombosis agents. RESULTS: The use of dual or triple 
      antiplatelet (AP) agents (HR:2.03, 95% CI:1.01-4.13, p = 0.04) and the 
      combination of an AP agent and warfarin (WF) (HR:4.84, 95%CI 1.96-11.96, p < 
      0.001) were associated with an increase in hemorrhagic events compared with no 
      use of anti-thrombosis agents. No anti-thrombosis regimen was associated with a 
      significant change in risk of ischemic stroke. The use of dual or triple AP 
      agents, but not WF, was associated with an increase in cardiovascular mortality 
      (HR:2.48, 95% CI:1.24-4.76, p = 0.01). CONCLUSION: A significant increase in 
      hemorrhagic events by the use of dual or more AP agents and by co-administration 
      of an AP agent and WF in patients on HD should be considered in planning their 
      anti-thrombosis regimen.
CI  - (c) 2017 The Author(s). Published by S. Karger AG, Basel.
FAU - Tanaka, Marenao
AU  - Tanaka M
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Moniwa, Norihito
AU  - Moniwa N
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Ohnishi, Hirofumi
AU  - Ohnishi H
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
AD  - Department of Public Health, Sapporo Medical University School of Medicine, 
      Sapporo, Japan.
FAU - Yamashita, Tomohisa
AU  - Yamashita T
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Koyama, Masayuki
AU  - Koyama M
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Gocho, Yufu
AU  - Gocho Y
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Nishizawa, Keitaro
AU  - Nishizawa K
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Kimura, Yukishige
AU  - Kimura Y
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Sugawara, Hirohito
AU  - Sugawara H
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Murakami, Sayaka
AU  - Murakami S
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Okazaki, Yusuke
AU  - Okazaki Y
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Furuhashi, Masato
AU  - Furuhashi M
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Yoshida, Hideaki
AU  - Yoshida H
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
FAU - Miura, Tetsuji
AU  - Miura T
AD  - Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo, Japan.
LA  - eng
PT  - Journal Article
DEP - 20170918
PL  - Switzerland
TA  - Kidney Blood Press Res
JT  - Kidney & blood pressure research
JID - 9610505
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Aged
MH  - Female
MH  - Fibrinolytic Agents/adverse effects/*therapeutic use
MH  - Hemorrhage/*chemically induced/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Aggregation Inhibitors/adverse effects/*therapeutic use
MH  - Renal Dialysis
MH  - Renal Insufficiency, Chronic/complications/*drug therapy/mortality
MH  - Risk Factors
MH  - Warfarin/adverse effects/therapeutic use
OTO - NOTNLM
OT  - Anti-thrombosis agent
OT  - Hemodialysis
OT  - Hemorrhagic event
OT  - Mortality
EDAT- 2017/09/19 06:00
MHDA- 2018/06/26 06:00
CRDT- 2017/09/19 06:00
PHST- 2016/12/16 00:00 [received]
PHST- 2017/04/19 00:00 [accepted]
PHST- 2017/09/19 06:00 [pubmed]
PHST- 2018/06/26 06:00 [medline]
PHST- 2017/09/19 06:00 [entrez]
AID - 000480487 [pii]
AID - 10.1159/000480487 [doi]
PST - ppublish
SO  - Kidney Blood Press Res. 2017;42(3):553-564. doi: 10.1159/000480487. Epub 2017 Sep 
      18.