Aspirin not linked to nonfatal atherosclerotic CVD, death in patients with CKD
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Key takeaways:
- Aspirin was not tied to nonfatal atherosclerotic CVD or cardiovascular death.
- Major bleeding incidence was higher in aspirin users.
Aspirin was not linked to the risk of nonfatal atherosclerotic CVD or cardiovascular death in adults with chronic kidney disease, according to recently published data.
However, it may increase the risk of major bleeding events, researchers found.
“Compared with the general population, patients with CKD have a disproportionately higher risk of cardiovascular disease (CVD), even in the early stages of CKD,” Jae Young Kim, MD, PhD, of the department of internal medicine at National Health Insurance Service Ilsan Hospital in the Republic of Korea, wrote with colleagues. “Notably, CVD among these patients. Therefore, identifying and establishing strategies to reduce the risk of CVD is of paramount importance for patients with CKD.”
Kim and colleagues assessed the effects of aspirin in patients aged 40 to 79 years, with CKD stages G3 and G4, who had no prior history of CVD. Using data from a nationwide South Korean cohort, researchers studied 15,861 patients with eGFRs between 15 mL/min/1.73 m²to 59 mL/min/1.73 m², who had routine health exams between 2011 and 2016.
The cohort was newly prescribed aspirin at a daily dose of 100 mg and were matched with 79,305 non-users. The primary outcome was nonfatal atherosclerotic CVD or cardiovascular death, and the main safety objective was intracranial or gastrointestinal bleeding-related hospitalization.
During a mean 6.9-year follow-up, nonfatal atherosclerotic CVD or cardiovascular death incidence rates were eight per 1,000 person-years in aspirin users compared with nine per 1,000 person-for non-aspirin users, according to the results.
Starting aspirin was not associated with the main efficacy outcome, researchers noted.
Major bleeding incidence was higher in aspirin users, with rates of 6.7 per 1,000 person-years compared with 4.7 per 1,000 person-years for non-users, the researchers found.
“Despite the lack of definitive evidence, aspirin is commonly prescribed to CKD patients without a history of CVD in real-world practice,” the researchers wrote. “This study highlights the need for careful consideration when prescribing aspirin for the primary prevention of CVD in patients with CKD, as the potential bleeding risk of aspirin may outweigh its benefits.”
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