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

Citation

Wolfe, R and Wetmore, JB and Woods, RL and McNeil, JJ and Gallagher, H and Roderick, P and Walker, R and Nelson, MR and Reid, CM and Shah, RC and Ernst, ME and Lockery, JE and Tonkin, AM and Abhayaratna, WP and Gibbs, P and Wood, EM and Mahady, SE and Williamson, JD and Donnan, GA and Cloud, GC and Murray, AM and Polkinghorne, KR, on behalf of the ASPREE Investigator Group, Subgroup analysis of the ASPirin in Reducing Events in the Elderly randomized clinical trial suggest aspirin did not improve outcomes in older adults with chronic kidney disease, Kidney International, 99, (2) pp. 466-474. ISSN 0085-2538 (2020) [Refereed Article]

Copyright Statement

Copyright 2020 Published by Elsevier, Inc., on behalf of the International Society of Nephrology

DOI: doi:10.1016/j.kint.2020.08.011

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.

Item Details

Item Type:Refereed Article
Keywords:chronic kidney disease, aspirin, bleeding, cardiovascular events, elderly, randomized clinical trial
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Nephrology and urology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Nelson, MR (Professor Mark Nelson)
ID Code:141791
Year Published:2020
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-11-19
Last Modified:2021-03-16
Downloads:0

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