The role of prophylactic use of low molecular weight heparin or aspirin in thromboembolic events in primary membranous nephropathy

Abstract

Objective: The aim of this study is to investigate the role of prophylactic anticoagulation regimens based on low molecular weight heparin (LMWH) or aspirin in thromboembolic events in patients with primary membranous nephropathy (PMN). Methods: A total of 717 patients with PMN were consecutively enrolled in this retrospective study. The propensity score matching method was utilized to adjust for the selection bias inherent in an analysis of outcomes, which was stratified by the anticoagulation prophylaxis regimen. Results: According to the anticoagulation prophylaxis regimen, patients were assigned into three groups: only LMWH therapy (L + A-, n = 53), only aspirin therapy (L - A+, n = 97), and no therapy of LMWH or aspirin (L - A-, n = 567). After performing 1:1 match, 37 patients were selected in the L + A - group and the L - A- group, respectively, and 94 patients were selected in the L - A+ group and the L - A- group, respectively. It showed that the prophylactic use of LMWH had no protective effects on arterial thromboembolic events (ATEs) (10.8% vs. 21.6%, p = .21) or venous thromboembolic events (VTEs) (8.1% vs. 10.8%, p = .69). The incidence of VTEs in the L - A+ group was lower than the L - A- group (2.1% vs. 10.6%, p = .02), while there were no significant differences in the incidences of ATEs between the L - A+ group and the L - A- group (5.3% vs. 7.4%, p = .55). Conclusions: The prophylactic use of LMWH showed no benefits on the incidence of ATEs or VTEs in patients with PMN. Aspirin effectively decreased the incidence of VTEs, without effects on the occurrence of ATEs.

Keywords: Primary membranous nephropathy; arterial; aspirin; low molecular weight heparin; thromboembolism.