Primary Prevention Aspirin, Lipoprotein(a), and Cardiorenal Outcomes in Chronic Kidney Disease: Chronic Renal Insufficiency Cohort
Authors' conclusion
Individuals with CKD and elevated Lp(a) without clinical CVD may derive net benefit from low-dose aspirin for the primary prevention of MI and ESRD.
Study context
- Population
- Individuals with chronic kidney disease (CKD) without clinical cardiovascular disease (CVD) in the Chronic Renal Insufficiency Cohortparticipants without clinical CVD
- Participants
- 2,552 individuals
- Exposure
- association of aspirin use with myocardial infarction (MI), stroke, end-stage renal disease (ESRD), and major bleeding events, stratified by Lp(a) ≥50 vs <50 mg/dL
Methodological detailsLp(a) measured at baseline and not reported to clinicians, aspirin use self-reported and longitudinally assessed at each follow-up visit, stratified by Lp(a) ≥50 vs <50 mg/dL
- Lp(a) measured at baseline and not reported to clinicians
- Aspirin use self-reported and longitudinally assessed at each follow-up visit
- Stratified by Lp(a) ≥50 vs <50 mg/dL
Main finding
As reported in the abstract
MI · median follow-up of 15.7 years
aspirin useHazard ratio (95% CI)
Lp(a) ≥50 mg/dL; 38% lower risk
0.62(0.42–0.91)
Lp(a) <50 mg/dL
1.38(1.07–1.77)
Observational data: associations, not effects.
Further findings
ESRD · median follow-up of 15.7 years
| Comparison | HR (95% CI) | |
|---|---|---|
| Aspirin use · Lp(a) ≥50 mg/dL; 28% lower risk | 0.72 (0.59–0.89) | |
| Aspirin use · Lp(a) <50 mg/dL | 0.98 (0.84–1.15) | |
| 0.512Hazard ratio (log scale) |
Stroke
- Aspirin use was not significantly associated with stroke in either Lp(a) group
Baseline characteristics
- Mean age
- 55.8 years
- Women
- 48%
- Reported aspirin use at baseline
- 34%
- Lp(a) ≥50 mg/dL
- 27%
- Mean estimated glomerular filtration rate
- 47 mL/min/1.73 m²
Safety
Major bleeding
- Aspirin use was not significantly associated with major bleeding in either Lp(a) group
Original publication
Primary Prevention Aspirin, Lipoprotein(a), and Cardiorenal Outcomes in Chronic Kidney Disease: Chronic Renal Insufficiency Cohort. JACC Adv. Published 19 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it