Logo image
Subgroup analysis of the ASPirin in Reducing Events in the Elderly randomized clinical trial suggests aspirin did not improve outcomes in older adults with chronic kidney disease
Journal article   Peer reviewed

Subgroup analysis of the ASPirin in Reducing Events in the Elderly randomized clinical trial suggests aspirin did not improve outcomes in older adults with chronic kidney disease

Rory Wolfe, James B. Wetmore, Robyn L. Woods, John J. McNeil, Hugh Gallagher, Paul Roderick, Rowan Walker, Mark R. Nelson, Christopher M. Reid, Raj C. Shah, …
Kidney international, Vol.99(2), pp.466-474
02/2021
DOI: 10.1016/j.kint.2020.08.011
PMCID: PMC7957958
PMID: 32920022
url
https://openresearch-repository.anu.edu.au/bitstreams/1d561a07-bc6d-456c-b98d-47acb69f8b7b/downloadView
Open Access

Abstract

The role of aspirin for primary prevention in older adults with chronic kidney disease (CKD) is unclear. Therefore, post hoc analysis of the randomized controlled trial ASPirin in Reducing Events in the Elderly (ASPREE) was undertaken comparing 100 mg of enteric-coated aspirin daily against matching placebo. Participants were community dwelling adults aged 70 years and older in Australia, 65 years and older in the United States, all free of a history of dementia or cardiovascular disease and of any disease expected to lead to death within five years. CKD was defined as present at baseline if either eGFR under 60mL/min/1.73m2 or urine albumin to creatinine ratio 3 mg/mmol or more. In 4758 participants with and 13004 without CKD, the rates of a composite endpoint (dementia, persistent physical disability or death), major adverse cardiovascular events and clinically significant bleeding in the CKD participants were almost double those without CKD. Aspirin’s effects as estimated by hazard ratios were generally similar between CKD and non-CKD groups for dementia, persistent physical disability or death, major adverse cardiovascular events and clinically significant bleeding. Thus, in our analysis aspirin did not improve outcomes in older people while increasing the risk of bleeding, with mostly consistent effects in participants with and without CKD. [Display omitted]
aspirin bleeding cardiovascular events chronic kidney disease elderly randomized clinical trial

Details

Logo image