Do Non-Selective NSAIDs Increase Out-of-Hospital Cardiac Arrest Risk

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Researchers found that use of NSAIDs like naproxen and ibuprofen were linked to increased out-of-hospital cardiac arrest risk.
Researchers found that use of NSAIDs like naproxen and ibuprofen were linked to increased out-of-hospital cardiac arrest risk.

The use of non-selective non-steroidal anti-inflammatory drugs (NSAIDs) was associated with a higher early risk of out-of-hospital cardiac arrest (OHCA), according to new research published in the European Heart Journal - Cardiovascular Pharmacotherapy.

NSAIDs, a commonly used drug class, are associated with increased cardiovascular risk but it is not clear whether it is associated with OHCA. Researchers from Copenhagen University Hospital Gentofte, Denmark, obtained data from the nationwide Danish Cardiac Arrest Registry for all patients with OHCA during 2001–2010. 

Use of NSAIDs 30 days prior to OHCA was categorized as diclofenac, naproxen, ibuprofen, rofecoxib, celecoxib, and other. The risk of OHCA associated with NSAIDs use was calculated by matching 4 controls on gender and age per case to adjust for differences in drug use over time. A total of 28,947 patients with OHCA were identified, of which 3,376 were treated with an NSAID up to 30 days before OHCA. 

The analysis indicated ibuprofen and diclofenac were the most commonly used NSAIDs, comprising 51.0% and 21.8% of total NSAID use, respectively. A significantly increased risk of OHCA was seen with the use of diclofenac (odds ratio [OR] 1.50, 95% CI: 1.23–1.82) and ibuprofen (OR 1.31, 95% CI: 1.14–1.51). The use of naproxen (OR 1.29, 95% CI: 0.77–2.16), celecoxib (OR 1.13, 95% CI: 0.74–1.70), and rofecoxib (OR 1.28, 95% CI: 0.74–1.70) was not significantly associated with increased OHCA risk but these groups consisted of few events. 

In conclusion, the use of non-selective NSAIDs was linked to an increased early risk of OHCA. "The result was driven by an increased risk of OHCA in ibuprofen and diclofenac users," study authors concluded. 

Reference

Sondergaard KB, Weeke P, Wissenberg M, et al. Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case-time-control study. Eur Heart J Cardiovasc Pharmacother. 2017;3(2):100-107. doi: 10.1093/ehjcvp/pvw041


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