Daily Aspirin Shows No Clear Heart Benefit in Kidney Trial
For adults with chronic kidney disease, a new trial finds that daily aspirin did not significantly lower major heart event risks.
Updated on Oct. 24, 2026 in Heart Disease
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Should patients with chronic kidney disease take daily aspirin to prevent cardiovascular events?
The ATTACK trial found no statistically significant reduction in major cardiovascular events for patients with chronic kidney disease taking daily aspirin. The study evaluated whether this patient population could safely benefit from aspirin for primary cardiovascular prevention.
Why it matters
Clinicians and patients with chronic kidney disease are seeking clarity on whether daily aspirin provides a net benefit for heart health. This study highlights the ongoing challenge of balancing cardiovascular protection against the risks of bleeding in this high-risk group.
This open-label randomized trial followed 4,633 participants for a mean of 3.1 years. While researchers observed 56 primary cardiovascular events in the aspirin group compared to 76 in the control arm, the findings did not reach statistical significance, and the net clinical benefit remains unresolved.
The details
The trial compared 75 mg of daily aspirin against no aspirin to assess its role in primary cardiovascular prevention among patients with chronic kidney disease. Researchers identified eligible participants through automated coding of primary care records. While the hazard ratio for major cardiovascular events was 0.73, investigators also tracked major bleeding and mortality to weigh overall safety, noting a hazard ratio of 1.54 for major bleeding and 1.11 for all-cause mortality.
Timeline
March 2019: Trial enrollment began.
March 2020: The trial was paused due to the COVID-19 pandemic.
March 2021: Researchers restarted the trial using remote procedures.
December 2023: The follow-up period for all participants ended.
October 2026: Trial results were presented at ASN Kidney Week 2026.
Health Landscape
The study sits within the broader, evolving search for effective primary cardiovascular prevention strategies for those with chronic kidney disease. These results contribute to the ongoing efforts to determine how standard heart health interventions should be modified for patients with reduced renal function.
Patients managing chronic kidney disease should discuss any questions regarding daily aspirin use with their physician to weigh potential cardiovascular benefits against bleeding risks. This study reinforces why clinical decisions should be individualized rather than based on general prevention guidelines.
The takeaway
The ATTACK trial underscores that daily aspirin does not provide a statistically significant reduction in major cardiovascular events for all patients with chronic kidney disease. Speak with your healthcare provider to review your specific cardiovascular risk profile and current medication regimen.
Further reading
Learn more about managing heart health in our Heart Disease section.
Source note: This article includes information reported by Hcplive.
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Should patients with chronic kidney disease take daily aspirin to prevent cardiovascular events?
