Program Book - Keck School of Medicine of USC - University of ...

PrePostMedical Therapy• Clopidogrel (Plavix) vs Placebo• 877 pts at 9 centers with newly created fistula• Randomized to clopidogrel vs placebo• Primary endpoint: fistula thrombosis at 6 wks• 12.2% vs 19.5%, p 0.018• Secondary endpoint: failure of fistula for dialysis(pump rate > 300 mL/min during 8 of 12 dialysissessions)• 62% vs 60%, p NS• Clopidogrel ↓frequency of early thrombosis ofnew fistulas but does not ↑proportion of fistulasthat become suitable for dialysisJAMA. 2008;299(18):2164-2171Medical Therapy• Dipyridamole (Persantine) vs placebo• 649 pts at 13 centers with newly placed AVDG• Dipyridamole + aspirin (Aggrenox) vs placebo• Primary endpoint: loss of primary unassisted patency(patency without thrombosis or need for intervention)at 1 year) 28% vs 23%, p 0.001.• Secondary endpoint: cumulative graft failure anddeath No difference• Combination dipyridamole + aspirin had a significant,but modest effect in improving graft patencyN Engl J Med 2009;360:2191-201.134