Title:Cardiovascular Protection of Aspirin in Chronic Kidney Disease Patients:
An Updated Systematic Review and Meta-Analysis
Volume: 22
Issue: 4
Author(s): Ting Chen, Yunlei Deng and Rong Gong*
Affiliation:
- Department of Nephrology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of
Chengdu, Chengdu, China
Keywords:
Cardiovascular protection, chronic kidney disease, aspirin, prevention, meta-analysis, bleeding, mortality.
Abstract:
Purpose: To evaluate aspirin's cardiovascular (CV) protective effect in chronic kidney disease
(CKD) patients.
Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science (up to December
2022) for randomized controlled trials (RCTs) and observational studies comparing aspirin with placebo
in CKD patients for the prevention of CV disease (CVD). Efficacy outcomes included CVD, heart failure,
myocardial infarction, stroke, CV and all-cause mortality; safety outcomes included major bleeding,
minor bleeding, and renal events.
Results: Six RCTs and 6 observational studies, including 35,640 participants, met the inclusion criteria
and reported relevant CV outcomes, with a mean follow-up of 46.83 months. The pooled data showed
aspirin had no significant preventive effect on CVD events (RR=1.03; 95% CI, 0.84-1.27). However,
CV mortality was significantly reduced in the aspirin group (RR=0.74; 95% CI, 0.58-0.95). Furthermore,
aspirin use did not increase the risk of major bleeding and renal events but significantly increased
minor bleeding events (RR=2.11; 95% CI, 1.30-3.44). Renal events were significantly increased after
sensitivity analysis (RR=1.10; 95% CI, 1.04-1.16).
Conclusion: Aspirin did not prevent CV events, with a significantly increased risk of minor bleeding
and renal events. Besides, aspirin use had no statistically significant reduction in the risk of all-cause
mortality but had a statistically significant reduction in the risk of CV mortality.
