NSAID Use Mediates CVD Risk in Osteoarthritis

NSAIDs in Chronic Ischemic Heart Disease
NSAIDs in Chronic Ischemic Heart Disease
Nonsteroidal anti-inflammatory drug use mediated a substantial amount of cardiovascular disease risk in osteoarthritis.

Nonsteroidal anti-inflammatory drug (NSAID) use in osteoarthritis increases the risk for cardiovascular disease (CVD), according to research presented at the European League Against Rheumatism (EULAR) Congress held in Amsterdam, June 13-16, 2018.1

Investigators used data from a population-based cohort of 720,055 Canadians to compare patients with osteoarthritis (n=7743) with people who did not have osteoarthritis (controls; n=23,229) in a 1:3 ratio. The primary outcome was the risk of developing CVD. Secondary outcomes were the presence of ischemic heart disease, congestive heart failure, and stroke.

Patients with osteoarthritis had a 23% higher risk for CVD developing compared with individuals without osteoarthritis, after adjusting for body mass index, diabetes, hypertension, hyperlipidemia, chronic obstructive pulmonary disease, socioeconomic status, and Romano comorbidity scores (adjusted hazard ratio, 1.23; 95% CI, 1.17-1.29). The adjusted hazard ratios for ischemic heart disease, congestive heart failure, and stroke were 1.17 (95% CI, 1.10-1.27), 1.42 (95% CI, 1.33-1.52), and 1.14 (95% CI, 1.08-1.24), respectively.

Current NSAID use mediated 67.5% of the total effect of osteoarthritis on the increased risk for CVD. Similarly, NSAID use mediated 44.7% of the increased risk for congestive heart failure and >90% of the total effect of osteoarthritis on both ischemic heart disease and stroke risk was mediated through NSAID use.

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In a statement released by EULAR, study author Aslam Anis, PhD, FCAHS, of the School of Population and Public Health at the University of British Columbia in Vancouver, Canada, noted that the findings suggest osteoarthritis is an independent risk factor for CVD and that NSAIDs contribute substantially to that risk, which is especially important given that NSAIDs are often used to manage pain in patients with osteoarthritis.2


  1. Atiquzzaman M, Kopec J, Karim ME, Wong H, Anis A. he role of NSAIDs in the association between osteoarthritis and cardiovascular diseases: a population-based cohort story. Presented at: European League Against Rheumatism (EULAR) Congress 2018; June 13-16, 2018; Amsterdam, The Netherlands. Abstract OP0190.
  2. NSAIDs shown to have causal role in cardiovascular risk of patients with osteoarthritis [press release]. Amsterdam, The Netherlands: Annual European Congress of Rheumatology; June 13, 2018.

This article originally appeared on Rheumatology Advisor