Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease
Authors: R. Brooks Robey, Daniel J. O'Rourke
Journal: Annals of Internal Medicine (2012)

Letters21 August 2012Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney DiseaseR. Brooks Robey, MD and Daniel J. O'Rourke, MDR. Brooks Robey, MDFrom Veterans Affairs Medical Center and Geisel School of Medicine at Dartmouth, White River Junction, VT 05009.Search for more papers by this author and Daniel J. O'Rourke, MDFrom Veterans Affairs Medical Center and Geisel School of Medicine at Dartmouth, White River Junction, VT 05009.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-4-201208210-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The systematic review and meta-analysis by Palmer and colleagues (1) found limited objective evidence to support antiplatelet therapy in patients with CKD. We concur with their assessment but believe that they underestimated the benefits and overemphasized the risks by introducing subjective bias into their analysis and interpretation of the data.Several of the study authors previously reported reduced cardiovascular events and mortality in hypertensive patients with CKD receiving low-dose aspirin relative to their counterparts with normal kidney function (2, 3). Apparent benefits were observed in all outcome categories and were greatest in patients with stage 3B or ...References1. Palmer SC, Di Micco L, Razavian M, Craig JC, Perkovic V, Pellegrini F, et al. Effects of antiplatelet therapy on mortality and cardiovascular and bleeding outcomes in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;156:445-59. [PMID: 22431677] LinkGoogle Scholar2. Jardine MJ, Ninomiya T, Perkovic V, Cass A, Turnbull F, Gallagher MP, et al. Aspirin is beneficial in hypertensive patients with chronic kidney disease: a post-hoc subgroup analysis of a randomized controlled trial. J Am Coll Cardiol. 2010;56:956-65. [PMID: 20828648] CrossrefMedlineGoogle Scholar3. Choi MJ, Fried LF. Chronic kidney disease and progression. Nephrology Self-Assessment Program, American Society of Nephrology; 2011;10:491-3. Google Scholar4. McQuaid KR, Laine L. Systematic review and meta-analysis of adverse events of low-dose aspirin and clopidogrel in randomized controlled trials. Am J Med. 2006;119:624-38. [PMID: 16887404] CrossrefMedlineGoogle Scholar5. Daugirdas JT. Handbook of Chronic Kidney Disease Management. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins Health; 2011. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Veterans Affairs Medical Center and Geisel School of Medicine at Dartmouth, White River Junction, VT 05009.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease Suetonia C. Palmer , Lucia Di Micco , Mona Razavian , Jonathan C. Craig , Vlado Perkovic , Fabio Pellegrini , Massimiliano Copetti , Giusi Graziano , Gianni Tognoni , Meg Jardine , Angela Webster , Antonio Nicolucci , Sophia Zoungas , and Giovanni F.M. Strippoli Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease Giovanni F.M. Strippoli , Suetonia C. Palmer , and Jonathan C. Craig Effects of Antiplatelet Therapy on Mortality and Cardiovascular and Bleeding Outcomes in Persons With Chronic Kidney Disease William Kussmaul Metrics Cited byImpact of Antiplatelet Therapy and Platelet Reactivity Testing on Cardiovascular Outcomes in Patients with Chronic Kidney Disease 21 August 2012Volume 157, Issue 4Page: 302-303KeywordsAntiplatelet therapyHemorrhagePlateletsRenal analysisRenal failureStatistical dataSystematic reviews ePublished: 21 August 2012 Issue Published: 21 August 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...