RALiC study
Research type
Research Study
Full title
Stratifying clinical risk in patients with atrial fibrillation and chronic kidney disease by studying how abnormalities in clot structure/function and lipoproteins contribute to thrombosis and bleeding
IRAS ID
262727
Contact name
Gregory YH Lip
Contact email
Sponsor organisation
University of Liverpool
Clinicaltrials.gov Identifier
1215, Liverpool Heart and Chest Hospital reference number
Duration of Study in the UK
2 years, 11 months, 27 days
Research summary
Research Summary
Patients with an irregular heart beat (‘atrial fibrillation’) are at risk of clot formation causing a stroke. Therefore, they are routinely offered blood-thinning medications (like warfarin) to reduce their risk. However, a similar approach in patients with kidney failure is ineffective at reducing stroke risk while subjecting patients to a significant risk of bleeding. At present, physicians are left with limited treatment options in such patients. In our previous study, we showed differences in clot properties among patients with kidney failure compared to those without. The mechanism by which this occurs is poorly understood. One possible explanation may lie with specific fatty molecules. Separate independent studies have shown that there are changes to specific fatty molecules in kidney failure and that these molecules can affect the clot properties. Therefore, our current study aims to evaluate the effects of kidney failure on these fatty molecules, and investigate their role as possible intermediaries to explain changes seen in clot properties. Blood samples from patients with both conditions will be analysed for specific fat molecules and clot properties, and compared to control groups. We will also analyse the effects of warfarin and high-intensity cholesterol-lowering medications in patients with atrial fibrillation and kidney failure.
Summary of Results
In this prospective study on the effects of AF and CKD, there are important changes that occur in fibrin clot properties with both these conditions that may account the in-creased risk of thromboembolic complications. However, these changes in fibrin clot properties were not attributable to alterations in lipoprotein distribution, specifically TC, LDL-C, sdLDL and OxLDL.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
19/NW/0355
Date of REC Opinion
5 Jul 2019
REC opinion
Further Information Favourable Opinion