Prevalence of Aspirin Resistance in Patients of Chronic Kidney Disease

Background: Chronic renal failure (CRF) is associated with increased risk of cardiovascular morbidity and mortality. Antiplatelets especially low dose aspirin becomes mandatory for prevention of primary and secondary prevention of cardiovascular events in patients of CKD. The aim of this study was to explore the prevalence of aspirin resistance in CRF. Methods: A prospective clinical study was conducted in which 130 patients suffering from CRF with concomitant cardiovascular risk factors were recruited and were on aspirin (100 mg daily) for 4 weeks. Aspirin non-responder status was identified by PFA-100 system. Results: Aspirin resistance was detected in 53 patients undergoing hemodialysis, 32 patients with stage 3-4 CKD and 22 controls. The frequency of aspirin resistance was significantly higher in the CRF group compared with controls (34.7% vs. 16.9%, P < 0.001) and in hemodialysis patients (46.1%) compared with stage 3-4 CKD patients (24.6%, P < 0.001) and controls (16.9%, P < 0.001). Multivariate analysis revealed female sex (odds ratio (OR) = 2.201; 95% confidence interval (95% CI), 1.173 - 4.129; P = 0.014), hemodialysis (OR = 3.636; 95% CI, 1.313 - 10.066; P = 0.013) and HDL cholesterol (OR = 0.974; 95% CI, 0.950 - 0.999; P = 0.043) as independent predictors of aspirin resistance in this cohort of patients. Conclusion: Patients with CRF have higher frequency of aspirin resistance. This might further increase the risk of cardiovascular morbidity and mortality in these patients. doi:10.4021/wjnu4w