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Is there a cardiovascular protective effect of aspirin in chronic kidney disease patients? A systematic review and meta-analysis.

Abstract：

PURPOSE:To perform a systematic review and meta-analysis to evaluate the cardiovascular prevention effect of aspirin among patients with chronic kidney disease (CKD). METHODS:A comprehensive literature search was conducted in Embase, PubMed, and Cochrane library (up to March 2019) without language limitations. Randomized control trials (RCT) and observational studies that met the inclusion and exclusion criteria were included. Two reviewers independently extracted data, and evaluated study quality using modified Jadad score for RCTs and Newcastle-Ottawa Scale for observational study. A meta-analysis was conducted in the Stata 15.0 software using the DerSimonian and Laird random-effects model. RESULTS:1768 references were identified from literature searching. Four RCTs and four cohort studies that reported the cardiovascular prevention outcome of aspirin in CKD patients (38,341 participants) were included in this review. The pooled data revealed that aspirin had no significant prevention effect on cardiovascular events among CKD patients (RR = 0.96, 95% CI, 0.59-1.13). There was also no significant reduction in cardiovascular mortality and all-cause mortality. Although we found no significant increased risk in major bleeding events, there was a statistically significant increased risk of minor bleeding events (RR = 2.57, 95% CI, 1.60-4.13) and renal events (RR = 1.30, 95% CI, 1.02-1.65) for aspirin use. CONCLUSION:Our review indicated that aspirin use in CKD patients had no prevention effect on cardiovascular events and no statistically significant reduction in risk of cardiovascular or all-cause mortality, with a significant increased risk of minor bleeding and renal events.

journal_name

Int Urol Nephrol

journal_title

International urology and nephrology

authors

Qu B,He Y,Wu L,Lu H,Wu H,Li M

doi

10.1007/s11255-019-02350-8

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

315-324

issue

2

eissn

0301-1623

issn

1573-2584

pii

10.1007/s11255-019-02350-8

journal_volume

52

pub_type

杂志文章,meta分析

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