Aspirin may prevent major adverse cardiovascular events (MACE) in patients with chronic kidney disease (CKD), according to study findings presented at the European Renal Association (ERA) 59th Congress held in Paris, France, and virtually.

The findings are from the International Polycap Study3 (TIPS3) study in which investigators randomly assigned 5713 individuals with and without CKD, but without previous cardiovascular (CV) disease, to receive aspirin, aspirin plus a polypill (containing atenolol, ramipril, hydrochlorothiazide, and simvastatin), a polypill alone, or respective placebo. Of the 5713 participants, 983 had CKD, defined as an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. The primary outcome was MACE, which included non-fatal myocardial infarction, non-fatal stroke, or CV-related death. Secondary outcomes included all-cause mortality. The mean follow-up duration was 4.6 years.

A total of 250 primary MACE occurred: 116 among aspirin recipients and 134 among placebo recipients, Johannes F.E. Mann, MD, from the University of Erlangen-Nürnberg and Munich General Hospitals in Germany, reported. Among patients with CKD, there were 65 primary MACE outcomes: 26 in the 502 participants on aspirin and 39 in the 481 participants on placebo. Aspirin use in those with CKD was significantly associated with a 43% reduction in MACE risk.

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Death from any cause occurred in 312 participants, with 82 occurring in the CKD group. Aspirin use was significantly associated with a 36% decreased risk for death compared with placebo.

For all participants, the aspirin-polypill combination was significantly associated with a 31% decreased risk for MACE and a nonsignificant 20% lower risk for death. Among patients with CKD, the combination treatment was significantly associated with a 63% and 51% decreased risk for MACE and death, respectively, compared with placebo.


Mann JFE, Joseph P, Gao P, et al. Effects of aspirin in primary prevention of cardiovascular (CV) disease in people with chronic kidney disease (CKD): Results of the TIPS3 trial. Presented at: ERA 2022, May 19-22, 2022, Paris, France. Abstract MO201.