HealthDay News – Use of prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) may be tied to a higher risk of heart failure, according to research published online in The BMJ.

Andrea Arfe, a PhD student at University of Milano-Bicocca in Italy, and colleagues analyzed European health records from 1999 through 2010. The patients came from Germany, Italy, the Netherlands, and the United Kingdom. The analysis included a total of 27 individual NSAIDs, including 23 traditional NSAIDs and 4 selective COX-2 inhibitors. The researchers identified 92,168 hospital admissions for heart failure, and matched those patients against 8,246,403 patients without such histories.

The team concluded that individuals who’d been prescribed an NSAID within the preceding 2 weeks had a 19% increased risk of hospital admission for heart failure. After accounting for other health factors — including history of kidney failure and risk factors for cardiovascular disease — the researchers determined that 7 traditional NSAIDs and 2 COX-2 inhibitors particularly increased risk of heart failure. The traditional NSAIDs were diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide, and piroxicam. The 2 COX-2 inhibitors are etoricoxib and rofecoxib (neither is approved for use in the United States). The COX-2 inhibitor celecoxib did not increase risk of heart failure at commonly used doses.


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Mr. Arfe told HealthDay that these findings “may have large public health consequences and they point to the need for further research to assess the safety of over-the-counter NSAIDs under the conditions they are typically used.”

Disclosures: Several members of the SOS Project Consortium (Drs Corrao, Straatman, Herings, Kollhorst, Schink, Garbe, Lucchi, Villa, Schuemie, Sturkenboom,and Varas-Lorenzo) disclosed financial ties to the pharmaceutical industry, including Novartis, Roche, GlaxoSmithKline, Bayer-Schering, Celgene, Mundipharma, Sanofi-Aventis, Sanofi-Pasteur, Stada, Takeda, Nycomed, Teva, Schwabe, Janssen, AstraZeneca, Pfizer, Eli Lilly, and Altana. A full list of disclosures can be found in the original paper online (see reference link below). 

References

  1. Arfe A, Scotti L, Varas-Lorenzo C, et al; on behalf of the Safety of Non-steroidal Anti-inflammatory Drugs (SOS) Project Consortium. Non-steroidal anti-inflammatory drugs and risk of heart failure in 4 European countries: nested case-control study. BMJ. 2016;354. doi:10.1136/bmj.i4857.
  2. Gislason GH, Torp-Pedersen C. NSAIDs and the failing heart. BMJ. 2016;354. doi:10.1136/bmj.i5163.