Prasugrel Versus High Dose Clopidogrel in Clopidogrel Resistant Patients Undergoing Chronic Hemodialysis

Inclusion criteria

• Age ≥18 years old
• History of chronic renal failure under hemodialysis for at least 6 months
• Under clopidogrel 75mg/day treatment for at least 7 days before randomization
• Informed consent obtained in writing

Exclusion criteria

• Treatment with other investigational agents (including placebo) or devices within 30 days prior to randomization or planned use of investigational agents or devices prior to the Day 30 visit.
• Pregnancy
• Breastfeeding
• Inability to give informed consent or high likelihood of being unavailable for the Day 30 follow up.
• Malignancy
• Acute coronary syndrome or hemodynamic instability within 30 days prior to randomization
• Requirement for oral anticoagulant prior to the Day 30 visit
• Requirement for discontinuation of thienopyridine treatment prior to the Day 30 visit
• Treatment with IIb/IIIa inhibitors within 30 days prior to randomization or planned administration prior to the Day 30 visit
• Known hypersensitivity to prasugrel or clopidogrel.
• History of gastrointestinal bleeding, genitourinary bleeding or other site abnormal bleeding within the previous 6 months.
• Other bleeding diathesis, or considered by investigator to be at high risk for bleeding on thienopyridine therapy.
• Any previous history of ischemic stroke, intracranial hemorrhage or disease (neoplasm, arteriovenous malformation, aneurysm).
• Thrombocytopenia (<100.000 / μL) at randomization
• Known liver failure (bilirubin > 2mg/dl)