Prophylactic add-on antiplatelet therapy in chronic kidney disease with type 2 diabetes mellitus: Comparison between clopidogrel and low-dose aspirin

Background: chronic kidney disease (ckd) coexisting with type 2 diabetes mellitus (dm) leads to coronary artery disease. the present study compares clopidogrel and low-dose aspirin as prophylactic therapy against coronary events in patients with ckd with diabetes. methods: total 80 patients of ckd with type 2 dm were randomized and allocated to clopidogrel and aspirin groups to receive the drug at a dose of 75 mg and 150 mg once daily respectively for 8 weeks as add-on therapy. main outcome was change in blood pressure,metabolic parameters,renal function,inflammatory biomarkers,platelet aggregability and (ukpds) united kingdom prospective diabetes study risk scoring. results: significant decrease in blood pressure (p < 0.01),total cholesterol (p = 0.02),ldl (p < 0.01),triglyceride (p < 0.01) and a better glycemic control (p < 0.01) was found in clopidogrel group. renal markers and electrolytes have been improved in clopidogrel group but in aspirin group there was deterioration (2.5%) of creatinine clearance. clopidogrel group has shown a significant decrease in hscrp (p < 0.01),ukpds risk scoring (p < 0.01) and better anti-aggregatory effect. conclusions: clopidogrel has prophylactic role in ckd with type 2 dm due to better control of metabolic parameters,renal function and inflammatory burden in comparison to aspirin.