Effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients

a randomized double-blind placebo-controlled trial

Abstract

Background: There is some evidence for the efficacy of antiplatelet therapies in increasing the vascular access patency duration or decreasing the thrombosis of arteriovenous grafts. Objective: To determine the effect of low dose aspirin and dipyridamole on primary patency of arteriovenous grafts in hemodialysis patients Methods: This randomized, double-blind, placebo-controlled trial was done at Imam Reza Hospital in Mashhad, Iran from September 10, 2015 to July 05, 2016. Sixty hemodialysis patients, after the placement of a new arteriovenous graft, were divided into three study groups which including; Group 1, who received 80 mg aspirin tablet daily, Group 2 received 80 mg aspirin plus 75 mg dipyridamole daily and Group 3 received placebo daily. Primary unassisted patency was recorded in follow-up until 12 months and the outcomes were analysed using one-way ANOVA test. Results: Primary patency time in Group 1 (Aspirin) was 324.75±147.00 day and for Group 2 (Aspirin + Dipyridamole) was 399.05±92.09 day and for Group 3 (Placebo) was 383.55±108.23 day. There were no significant differences between the 3 groups (p>0.05). Successful dialysis was done in 16.7% in Group 1, 37.5% in Group 2 and 45% in Group 3 from brachial arteriovenous grafts after 1-year follow-up (p=0.746). Conclusions: In treating dialysis patients, treatment with low dose aspirin and dipyridamole is not effective on increasing the synthetic grafts primary patency duration. Trial registration: The trial was registered at the Thai Clinical Trials Registry (http://www.clinicaltrials.in.th) with the Trct id: TCTR20160920003. Funding: The authors received no financial support for the research, authorship, and/or publication of this article.