Comparison of the effectiveness and safety of 2 aspirin doses in secondary prevention of cardiovascular outcomes in patients with chronic kidney disease: A subgroup analysis of ADAPTABLE
Authors' conclusion
Patients with CKD were more likely than those without CKD to have adverse cardiovascular events or death and were also more likely to have major bleeding requiring hospitalization. However, there was no association between ASA dose and study outcomes among these patients with CKD.
Study context
- Population
- ADAPTABLE participants with established CVD and a history of chronic kidney disease (CKD) (ICD-9/10-CM codes)2,648 (18%) with CKD
- Participants
- 14,662 participants
- Comparison
- Aspirin 81 mg vs 325 mg daily in patients with CKD
- Primary endpoint
- Composite of all-cause death, MI or stroke (effectiveness); hospitalization for major bleeding (safety)
- Follow-up
- Median 26.2 months
Methodological detailssubgroup analysis
- Subgroup analysis
Primary result
As reported in the abstract
Composite of:
- All-cause death
- MI or stroke (primary effectiveness outcome)
- In CKD
Adjusted hazard ratio (95% CI)P value
ASA groupsbetween ASA groups (81 mg vs 325 mg); direction not stated
1.01(0.82–1.23)
P = 0.95CKDvs No CKDregardless of ASA dose
1.79(1.57–2.05)
P < 0.001Safety
Hospitalization for major bleeding (primary safety outcome), in CKD · median follow-up 26.2 months
| Adjusted HR (95% CI) | P value | ||
|---|---|---|---|
| ASA groupsBetween ASA groups (81 mg vs 325 mg); direction not stated | 0.93 (0.52–1.64) | P = 0.79 | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Hospitalization for major bleeding (primary safety outcome), in CKD · median follow-up 26.2 monthsCKDvs No CKDRegardless of ASA dose | 4.64 (2.98–7.21) | P < 0.05 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Hospitalization for major bleeding (primary safety outcome), in CKD · median follow-up 26.2 months
- No significant difference in safety between ASA groups
Original publication
Comparison of the effectiveness and safety of 2 aspirin doses in secondary prevention of cardiovascular outcomes in patients with chronic kidney disease: A subgroup analysis of ADAPTABLE. Am Heart J. Published 7 June 2023. doi:10.
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