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首页> 外文期刊>Hemodialysis international >Low-dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5-y prospective cohort study
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Low-dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5-y prospective cohort study

机译：低剂量阿司匹林预防血液透析患者心血管疾病的5年前瞻性队列研究

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Introduction Aspirin is an effective antiplatelet drug for preventing cardiovascular events in high-risk subjects. However, for patients with chronic kidney disease and undergoing hemodialysis (HD), its preventive efficacy remains controversial. The present study aimed to determine whether aspirin therapy reduces the risk of cardiovascular disease (CVD) and all-cause mortality in patients on HD. Methods We conducted a 5-y prospective cohort study involving patients on HD. Major exposure variables included prescription of aspirin (100 mg/d) and no aspirin (nonaspirin). The primary outcomes included all-cause death, cardiovascular events, hemorrhage, and ischemic stroke. The secondary outcome included bleeding events defined by the requirement of hospitalization. Findings In this study, 406 patients on regular HD were involved during a 5-y follow-up. Among these, 152 and 254 propensity-matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the non-aspirin users (log rank chi(2) = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all-cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR = 1.795, 95% CI 0.666-4.841, P = 0.174). After adjustment for other con-founders, aspirin use was also not associated with decreased risk of all-cause mortality and CVD. Discussion The present prospective cohort study suggests that low-dose aspirin use is not associated with a significant decrease in the risks of all-cause mortality, CVD, and stroke in population undergoing HD (ClinicalTrials.gov number, NCT02261025).
机译：简介阿司匹林是一种有效的抗血小板药物，可预防高危人群的心血管事件。然而，对于患有慢性肾脏疾病并接受血液透析（HD）的患者，其预防功效仍存在争议。本研究旨在确定阿司匹林治疗是否可降低HD患者的心血管疾病（CVD）风险和全因死亡率。方法我们进行了一项为期5年的前瞻性队列研究，涉及HD患者。主要暴露变量包括阿司匹林（100 mg / d）处方和无阿司匹林（nonaspirin）处方。主要结果包括全因死亡，心血管事件，出血和缺血性中风。次要结果包括因住院需要而引起的出血事件。研究结果在5年的随访中，有406例常规HD患者参与了研究。在这些患者中，分别有152名和254名倾向匹配的患者参加了阿司匹林和非阿司匹林研究。阿司匹林的累积生存率并不显着高于非阿司匹林使用者（log rank chi（2）= 1.080，P = 0.299）。使用阿司匹林与降低全因死亡率，致命和非致命性充血性心力衰竭以及急性心肌梗塞和缺血性卒中并没有显着相关。阿司匹林使用者致命性脑出血的危险没有显着增加（HR = 1.795，95％CI 0.666-4.841，P = 0.174）。在对其他混杂因素进行调整之后，使用阿司匹林也不会降低全因死亡率和CVD的风险。讨论本项前瞻性队列研究表明，小剂量使用阿司匹林与HD人群中全因死亡率，CVD和中风的风险显着降低无关（ClinicalTrials.gov号，NCT02261025）。

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