Continuous aspirin treatment improves cardiovascular events and all-cause mortality in hemodialysis patients with peripheral artery disease.

IF 3 3区 医学 Q1 UROLOGY & NEPHROLOGY Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-07-22 DOI:10.1080/0886022X.2024.2380754
Chung-Kuan Wu, Noi Yar, Yun-Yi Chen
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Abstract

Background: Hemodialysis (HD) patients with peripheral arterial disease (PAD) are at heightened risk of adverse vascular events, and aspirin positively affects those outcomes. We aimed to investigate the association between different patterns of aspirin use and clinical vascular events in chronic HD patients with PAD.

Methods: This retrospective nationwide cohort study enrolled 758 chronic HD patients who had been diagnosed with PAD between January 1, 2008, and December 31, 2012, and followed up until the end of 2020. Patients were divided into three groups according to medication possession ratio (MPR) and continued use of aspirin (i.e., low MPR, high MPR but discontinuous prescription, and high MPR and continuous prescription). Percutaneous transluminal angioplasty (PTA), surgical bypass, lower leg amputation, cardiovascular events, cerebrovascular events, and all-cause mortality were evaluated.

Results: High MPR and continuous aspirin use had the lowest incidence of all-cause mortality and cardiovascular events compared with the two other groups, and it was significantly associated with low risk of PTA, surgical bypass, cardiovascular events, and all-cause mortality (aHR: 0.58 [0.41-0.83], 0.49 [0.25-0.95], 0.57 [0.40-0.81], and 0.70 [0.55-0.88], respectively). Kaplan-Meier analysis revealed that event-free rates of PTA, cardiovascular events, and all-cause mortality of patients with high MPR and continuous aspirin treatment were the highest among the three groups (p < 0.05).

Conclusion: Among HD patients with PAD, high MPR and continuous aspirin use significantly reduced the risk of PTA, surgical bypass, cardiovascular events, and all-cause mortality and improved the event-free rates of PTA, cardiovascular events, and all-cause mortality during long-term follow-up.

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持续服用阿司匹林可改善患有外周动脉疾病的血液透析患者的心血管事件和全因死亡率。
背景:患有外周动脉疾病(PAD)的血液透析(HD)患者发生不良血管事件的风险较高,而阿司匹林对这些结果有积极影响。我们旨在研究患有外周动脉疾病的慢性血液透析患者使用阿司匹林的不同模式与临床血管事件之间的关系:这项全国性回顾性队列研究共纳入了 758 名在 2008 年 1 月 1 日至 2012 年 12 月 31 日期间被诊断为 PAD 的慢性 HD 患者,并随访至 2020 年底。根据患者的药物拥有比(MPR)和持续使用阿司匹林的情况将其分为三组(即低MPR组、高MPR但不连续处方组和高MPR且连续处方组)。对经皮腔内血管成形术(PTA)、外科搭桥术、小腿截肢、心血管事件、脑血管事件和全因死亡率进行了评估:与其他两组相比,高MPR和持续服用阿司匹林组的全因死亡率和心血管事件发生率最低,且与PTA、手术搭桥、心血管事件和全因死亡率的低风险显著相关(aHR:分别为0.58 [0.41-0.83]、0.49 [0.25-0.95]、0.57 [0.40-0.81]和0.70 [0.55-0.88])。Kaplan-Meier 分析显示,高 MPR 和持续阿司匹林治疗患者的 PTA、心血管事件和全因死亡率的无事件发生率是三组中最高的(P 结论:高 MPR 和持续阿司匹林治疗患者的 PTA、心血管事件和全因死亡率的无事件发生率是三组中最高的:在患有 PAD 的 HD 患者中,高 MPR 和持续服用阿司匹林可显著降低 PTA、手术搭桥、心血管事件和全因死亡率的风险,并在长期随访中提高 PTA、心血管事件和全因死亡率的无事件发生率。
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来源期刊
Renal Failure
Renal Failure 医学-泌尿学与肾脏学
CiteScore
3.90
自引率
13.30%
发文量
374
审稿时长
1 months
期刊介绍: Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.
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