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Abstract: PO0543

During P2Y12 Antiplatelet Therapy, Treatment of Anemia Was More Frequent Among Peripheral Artery Disease Patients with Lower eGFR: The EUCLID Trial

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Hsia, Judith, CPC Clinical Research, Aurora, Colorado, United States
  • Kavanagh, Sarah T., CPC Clinical Research, Aurora, Colorado, United States
  • Hopley, Charles W., Dartmouth College, Hanover, New Hampshire, United States
  • Bonaca, Marc P., CPC Clinical Research, Aurora, Colorado, United States
  • Hiatt, William R., CPC Clinical Research, Aurora, Colorado, United States
Background

Anemia independently predicts amputation and mortality among patients with peripheral artery disease (PAD). In the EUCLID trial, minor bleeding was more frequent among PAD patients with baseline eGFR<60 vs >60 ml/min/1.73m2 (adjusted HR 1.51, 95% CI 1.07-2.15; p=0.02 for TIMI minor bleeding; HR 1.21, 95% CI 0.89-1.64; p=0.22 for TIMI major bleeding). We evaluated the impact of eGFR on hemoglobin (Hb) levels and anemia treatment.

Methods

EUCLID (NCT01732822) randomized symptomatic PAD patients to monotherapy with ticagrelor or clopidogrel for 30 months (median); treatment groups were combined for analysis. Independent predictors of Hb change from baseline were evaluated in a multivariable model including baseline Hb and eGFR, sex, age, and post-randomization revascularization procedures, myocardial infarction and anemia treatment.

Results

At baseline, 9025, 1870 and 1000 patients had eGFR >60, 45-59 and <45 ml/min/1.73m2, respectively. Patients with lower eGFR were older, more often male and had higher prevalence of diabetes and hypertension. Mean Hb at baseline was 14.2, 13.5 and 12.7 g/dL for the 3 eGFR categories. Mean fall in Hb during the trial was 0.5+1.7 g/dL and did not differ by baseline eGFR category. On-study treatment with iron, erythropoietin and/or red blood cell transfusion was reported for 479 (5.3%), 165 (8.8%) and 129 (12.9%) patients, respectively (Figure, p<0.0001 across eGFR categories). In multivariable analysis, even after adjustment for baseline and post-randomization effects, baseline Hb was a significant independent predictor of Hb fall; anemia treatment was a significant independent predictor of Hb rise.

Conclusion

Among patients with PAD taking antiplatelet therapy in the EUCLID trial, those with lower eGFR were more often treated for anemia.

Funding

  • Commercial Support