Patients with chronic kidney disease (CKD) who also have established ischemic cardiovascular disease represent a high-risk population requiring targeted secondary prevention strategies. Managing cardiovascular risk in this setting requires careful consideration of evidence-based interventions appropriate for the combined clinical picture.
Chronic kidney disease in a patient with established ischemic cardiovascular disease — a comorbidity that directly shapes the secondary prevention approach.
An antiplatelet strategy forms the cornerstone of secondary prevention to reduce the risk of recurrent ischemic cardiovascular events in this population. The choice and tolerability of the specific agent determines the regimen selected.
Full protocol details, agent selection, alternatives, and clinical decision points are available via the structured regimen below.
DOI: 10.1016/j.kint.2023.10.018
We recommend oral low-dose aspirin for prevention of recurrent ischemic cardiovascular disease events (i.e., secondary prevention) in people with CKD and established ischemic cardiovascular disease (1C).
Consider other antiplatelet therapy (e.g., P2Y12 inhibitors) when there is aspirin intolerance.
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