Publication Spotlight: Dr. Mavrakanas

Read the below interview with Thomas Mavrakanas, MD, MSc, Assistant Professor, Department of Medicine, Division of Experimental Medicine, McGill University author of Prasugrel and Ticagrelor in Patients with Drug-Eluting Stents and Kidney Failure.

What question did your study aim to answer?

To determine whether prasugrel or ticagrelor is associated with improved cardiovascular outcomes compared with clopidogrel in patients with kidney failure on maintenance dialysis treated with drug-eluting stents.

What inspired you to conduct this study?

The high incidence of cardiovascular disease and major bleeding among patients with kidney failure on maintenance dialysis.

Which USRDS datasets did you use to conduct your study?

Core, Institutional Claims 2011-2015, Physician Supplier Claims 2011-2015, Part D 2011-2015, Pre-ESRD Institutional Claims 2011-2015, Pre-ESRD Physician Supplier Claims 2011-2015, Pre-ESRD Part D 2011-2015.

Using plain language, please summarize your study conclusions in two or three points.

The newer, more potent antiplatelet agents, prasugrel and ticagrelor, were of similar effectiveness as clopidogrel in patients on maintenance dialysis treated with a drug-eluting stent, and they were relatively well tolerated, with no significant increase in clinically significant bleeding.

Both agents could be considered in selected patients on maintenance dialysis with anatomically complex coronary disease treated with drug-eluting stents. The potential benefit should be balanced against a potentially higher risk of clinically relevant bleeding.

Please share a specific insight about working with USRDS data that you learned during the completion of this study.

USRDS is a comprehensive database offering probably the largest dataset of its kind in the world. Although the database is relatively complex to work with, it provides very important information in an understudied population and is an invaluable tool for researchers in kidney failure.