title: Use of aspirin associates with longer primary patency of hemodialysis grafts.
abstract: Extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts, but the individual contributions of each component are unknown. Here, we analyzed whether use of aspirin at baseline associated with primary unassisted graft patency among participants in a randomized trial that compared ERDP/ASA and placebo in newly created grafts. We used Cox proportional hazards regression, adjusting for prespecified baseline comorbidities and covariates. Of all participants, 43% reported use of aspirin at baseline; of these, 82% remained on nonstudy aspirin (i.e., excluding ERDP/ASA) at 1 year. After 1 year of follow-up, the incidence of primary unassisted patency among participants using aspirin at baseline was 30% (95% CI: 24 to 35%) and among those not using aspirin was 23% (95% CI: 18 to 27%). Use of aspirin at baseline associated with a dose-dependent prolongation of primary unassisted graft patency that approached statistical significance (adjusted HR, 0.83; 95% CI: 0.68 to 1.01; P=0.06). Use of aspirin at baseline did not associate with prolongation of cumulative graft patency or participant survival. In conclusion, use of aspirin associates with a trend toward longer primary unassisted patency of newly placed hemodialysis grafts similar to that observed for ERDP/ASA.
authors.affiliation: Division of Nephrology, University of Iowa College of Medicine, E-300D GH, 200 Hawkins Drive, Iowa City, IA 52242-1081, USA. bradley-dixon@uiowa.edu
authors.forename: Bradley S
authors.initials: BS
authors.lastname: Dixon
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Beck
authors.forename: Laura M
authors.initials: LM
authors.lastname: Dember
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Vazquez
authors.forename: Arthur
authors.initials: A
authors.lastname: Greenberg
authors.forename: James A
authors.initials: JA
authors.lastname: Delmez
authors.forename: Michael
authors.initials: M
authors.lastname: Allon
authors.forename: Jonathan
authors.initials: J
authors.lastname: Himmelfarb
authors.forename: Bo
authors.initials: B
authors.lastname: Hu
authors.forename: Tom
authors.initials: T
authors.lastname: Greene
authors.forename: Milena K
authors.initials: MK
authors.lastname: Radeva
authors.forename: Ingemar J
authors.initials: IJ
authors.lastname: Davidson
authors.forename: T Alp
authors.initials: TA
authors.lastname: Ikizler
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Braden
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Lawson
authors.forename: James R
authors.initials: JR
authors.lastname: Cotton
authors.forename: John W
authors.initials: JW
authors.lastname: Kusek
authors.forename: Harold I
authors.initials: HI
authors.lastname: Feldman
mesh_terms: D000328:Adult; D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects; D001241:Aspirin / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000068342:Aspirin, Dipyridamole Drug Combination; D002908:Chronic Disease; D004176:Dipyridamole / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D006435:Renal Dialysis / Q000379:methods*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D014654:Vascular Patency / Q000187:drug effects
chemical_list: D000068342:Aspirin, Dipyridamole Drug Combination; D004338:Drug Combinations; D010975:Platelet Aggregation Inhibitors; D004176:Dipyridamole; D001241:Aspirin