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논문분류	춘계학술대회 초록집
제목	The effect of aspirin on preventing primary vascular access dysfunction in the incident hemodialysis patients
저자	Chan Ho Kim, Hyung Jung Oh, Jae Hyun Chang, Dong-Ryeol Ryu
출판정보	2019; 2019(1):
키워드	aspirin \| vascular access failure \| incident hemodialysis
초록	Aspirin has been often prescribed empirically to improve the patency of hemodialysis (HD) vascular access. The aim of this study was to investigate the impact of aspirin on the survival of vascular access in incident HD patients with arteriovenous fistula (AVF) or graft (AVG). A prospective cohort of 881 incident HD patients between 2009 and 2015 were enrolled. The primary outcome was defined as the first AVF/AVG intervention or salvage procedure, including percutaneous transluminal angioplasty or surgery for vascular access failure. Moreover, Cox analyses were performed to determine the association between aspirin usage and occurrence of primary outcome. The mean age of patients was 57.9 ± 13.4 years, and 63.8% of the patients were male. Aspirin was prescribed in 241 (27.4%) patients. During a median follow-up duration of 30 months, 180 (20.4%) patients experienced primary outcome event. In univariate analysis, older age, female, the presence of diabetes mellitus (DM), preexisting peripheral arterial disease, and AVG (vs. AVF) were significantly associated with the development of primary outcome. However, aspirin usage from the baseline was not significantly associated with primary outcome events (HR: 1.16; 95% CI: 0.84-1.60; p = 0.378). In multivariate analysis, female, the presence of DM, and AVG were still significantly associated with the occurrence of primary outcome. Moreover, we could not find the protective effect of taking aspirin on the primary vascular access failure even in the subgroup analyses stratified according to gender, the presence of DM, and the type of vascular access. Physicians need to take careful consideration when they choose aspirin to prevent primary vascular access failure in the Korean incident HD patients. In the future, larger interventional prospective study will be needed to elucidate the effect of aspirin on the vascular access failure.
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