Abstract: FR-PO1065

Aspirin Treatment in Primary Cardiovascular Prevention and Renal Disease Progression in CKD Patients: A Randomized Clinical Trials (AASER Study)

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 305 CKD: Clinical Trials and Tubulointerstitial Disorders

Authors

  • Goicoechea, Marian, Hospital General Universitario Gregorio Marañon, Madrid, Spain
  • Garcia de vinuesa, Maria soledad, Hospital General Universitario Gregorio Marañon, Madrid, Spain
  • Quiroga, Borja, Hospital de La Princesa, Madrid, Spain
  • Verdalles, Ursula, Hospital Gregorio Marañon , Madrid, Spain
  • Morales, Enrique, HOSPITAL 12 DE OCTUBRE, MADRID, Spain
  • De Sequera, Patricia, University Hospital Infanta Leonor, Madrid, MAD, Spain
  • Fernandez Juarez, Gema, HOSPITAL DE ALCORCON, ALCORCON, Spain
  • Verde, Eduardo, Hospital General Universitario Gregorio Marañon, Madrid, Spain
  • Luno, Jose, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Background

Aspirin (ASA) use for primary cardiovascular disease (CV) prevention is controversial in general population. Chronic kidney disease (CKD) patients have a high CV risk but no evidence is available about the use of aspirin in CKD patients to decrease CV risk and to reduce renal disease progression.

Methods

We conducted a prospective, multicentric open randomized trial that included 111 patients with estimated GFR (eGFR) <60 ml/min (stage 3 and 4) without previous CV events. Patients were randomly assigned to treatment with aspirin 100 mg/day (n: 50) or to continue the usual therapy (n:61). Mean follow up time was: 63.6±16.4 months.
Outcomes: The primary end-point was a composite of non-fatal cardiovascular events and mortality. Secondary end-points included progression of renal disease doubling of serum creatinine, ≥50% decrease in estimated glomerular filtration rate or renal replacement therapy and bleeding episodes

Results

During long-term follow-up, 16 and 5 participants in control and ASA groups respectively suffered from a CV event (p=0.05). Eight patients suffered from a fatal or non-fatal coronary event in the control group and no patient in the ASA group experienced a coronary event (log rank 5.997, p=0.014). Seventeen patients in the control group reached the renal outcome in comparison with 3 patients in the ASA group (log rank: 5.849 p=0.016). Aspirin treatment decreased renal disease progression in a model adjusted for age, baseline kidney function and diabetes mellitus (HR, 0.272; 95% CI, 0.075-0.955; p= 0.045). No differences were found in bleeding episodes (2 in standard and 3 in ASA group)
Limitations: Small sample size and not double blind trial.

Conclusion

Long-term treatment with low dose aspirin decreases coronary events and may slow the rate of progression of kidney disease.