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Effect of ticagrelor on the function of tunneled cuffed catheter in maintenance hemodialysis patients

Jianming Shen1, Yanyan Deng1, Liping Wang1

  • 1Department of Nephrology, Renmin Hospital, Hubei University of Medicine, Shiyan, China.

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|March 8, 2023
PubMed

Insights

Ticagrelor did not extend the functional lifespan of tunneled cuffed catheters (TCC) in maintenance hemodialysis (MHD) patients compared to aspirin. The study found TCCs lasted longer in the aspirin group, suggesting ticagrelor may not be optimal for this indication.

Area of Science:

  • Nephrology
  • Vascular Access
  • Pharmacology

Background:

  • Tunneled cuffed catheters (TCC) are crucial for vascular access in maintenance hemodialysis (MHD).
  • Catheter dysfunction, often due to thrombosis, limits TCC lifespan and impacts patient treatment.
  • Antiplatelet therapy is used to maintain catheter patency, but optimal drug choice requires investigation.

Purpose of the Study:

  • To evaluate the efficacy of ticagrelor compared to aspirin in maintaining TCC function and longevity in MHD patients.
  • To assess the impact of ticagrelor on catheter dysfunction, coagulation, and adverse events.

Main Methods:

  • A prospective study enrolled 80 MHD patients with TCCs, divided into a control group (aspirin) and an observation group (ticagrelor).
  • Data collected included catheter lifespan, dysfunction rates, coagulation parameters, and adverse events over the study period.
  • Statistical analysis, including log rank test, was used to compare outcomes between the groups.

Main Results:

  • The median TCC lifespan was significantly longer in the control group (aspirin) compared to the observation group (ticagrelor).
  • Log rank test confirmed a statistically significant difference (p < 0.001) in catheter survival between the groups.
  • While ticagrelor was associated with reduced catheter dysfunction, this did not translate to a longer overall catheter lifespan in this study.

Conclusions:

  • Ticagrelor may reduce TCC dysfunction by preventing thrombosis, but it did not prolong catheter lifespan compared to aspirin in MHD patients.
  • Further research is needed to optimize antiplatelet strategies for TCCs in MHD to balance patency and longevity.
  • The findings suggest that ticagrelor might not be the preferred agent for maintaining TCC function in MHD patients, despite potential benefits in reducing dysfunction.
Abstract

Keywords:
dysfunctionmaintenance hemodialysisthrombosisticagrelortunneled cuffed catheter

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