ATTACK trial finds no significant benefit of aspirin for CKD primary prevention

The ATTACK trial, a pragmatic randomized trial conducted in UK primary care, has found no statistically significant reduction in major cardiovascular events for adults with chronic kidney disease (CKD) using low-dose aspirin for primary prevention.

While the study showed a 27% lower point estimate for cardiovascular events, the results did not reach statistical significance. Presented at the American Society of Nephrology (ASN) Kidney Week 2026, the findings leave unresolved whether aspirin can effectively prevent a first heart attack or stroke in this population without increasing bleeding risks.

Investigators noted that while CKD is strongly associated with cardiovascular disease, previous evidence was limited to small subgroups of general-population trials. Researchers stated that pooled analyses with other trials will be necessary before aspirin can be officially recommended for primary prevention in patients with CKD.