{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T22:28:39Z","timestamp":1776551319780,"version":"3.51.2"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,9,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Coronary stenting in patients on dialysis has increased by nearly 50% over the past decade, despite heightened risks of associated stent thrombosis and bleeding relative to the general population. We examined clopidogrel, prasugrel or ticlopidine use after percutaneous coronary intervention (\n              <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>\n              ) with stenting in patients on dialysis. We conducted 3\u2010, 6\u2010, and 12\u2010month landmark analyses to test the hypothesis that thienopyridine discontinuation prior to those time points would be associated with higher risks of death, myocardial infarction, or repeat revascularization, and a lower risk of major bleeding episodes compared with continued thienopyridine use.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the\n              <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content>\n              Renal Data System, we identified 8458 patients on dialysis with Medicare Parts A+B+D undergoing\n              <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>\n              with stenting between July 2007 and December 2010. Ninety\u2010nine percent of all thienopyridine prescriptions were for clopidogrel. At 3\u00a0months, 82% of patients who received drug\u2010eluting stents (\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              ) had evidence of thienopyridine use. These proportions fell to 62% and 40% at 6 and 12\u00a0months, respectively. In patients who received a bare\u2010metal stent (\n              <jats:styled-content style=\"fixed-case\">BMS<\/jats:styled-content>\n              ), 70%, 34%, and 26% of patients had evidence of thienopyridine use at 3, 6, and 12\u00a0months, respectively. In patients who received a\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              , there was a suggestion of higher risks of death or myocardial infarction associated with thienopyridine discontinuation in the 3\u2010, 6\u2010, and 12\u2010months landmark analyses, but no higher risk of major bleeding episodes. In patients who received a\n              <jats:styled-content style=\"fixed-case\">BMS<\/jats:styled-content>\n              , there were no differences in death or cardiovascular events, and possibly lower risk of major bleeding with thienopyridine discontinuation in the 3\u2010 and 6\u2010month landmark analyses.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The majority of patients on dialysis who undergo\n              <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>\n              discontinue thienopyridines before 1\u00a0year regardless of stent type. While not definitive, these data suggest that longer\u2010term thienopyridine use may be of benefit to patients on dialysis who undergo\n              <jats:styled-content style=\"fixed-case\">PCI<\/jats:styled-content>\n              with\n              <jats:styled-content style=\"fixed-case\">DES<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.001356","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T03:37:11Z","timestamp":1413949031000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Thienopyridine Use After Coronary Stenting in Low Income Patients Enrolled in Medicare Part D Receiving Maintenance Dialysis"],"prefix":"10.1161","volume":"3","author":[{"given":"Tara I.","family":"Chang","sequence":"first","affiliation":[{"name":"Division of Nephrology, Stanford University School of Medicine, Stanford, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria E.","family":"Montez\u2010Rath","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Stanford University School of Medicine, Stanford, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny I.","family":"Shen","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Los Angeles Biomedical Research Institute Harbor\u2010UCLA Medical Center, Torrance, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Glenn M.","family":"Chertow","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Stanford University School of Medicine, Stanford, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang C.","family":"Winkelmayer","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Stanford University School of Medicine, Stanford, CA"},{"name":"Section of Nephrology, Baylor College of Medicine, Houston, TX 77030\u20103411"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.11.042"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.08680910"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1023\/B:UROL.0000020356.82724.37"},{"key":"e_1_3_5_5_2","unstructured":"U.S. Renal Data System . 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