NSAIDs and cardiovascular risk

Nonselective nonsteroidal anti-inflammatory drugs (NSAIDs) increase the risk of heart attack and stroke in patients with rheumatoid arthritis (RA) according to a large Taiwanese study published in the American Journal of Cardiology (https://doi.org/10.1016/j.amjcard.2018.01.044)

Investigators conducted a case-crossover study of 5921 stroke or myocardial infarction (MI) patients who also had RA. Exposure to NSAIDs was compared during a case period (1 to 30 days before the index date) with a control period (91 to 120 days before the index date).

The results showed that overall, NSAID use increased the risk of stroke by 1.40-fold (95% confidence interval [CI] 1.25–1.56) and risk of MI by 1.73-fold (95% CI 1.29–2.32). After classifying NSAIDs into selective and nonselective groups, only nonselective NSAIDs significantly increased the risks of stroke (adjusted odds ratio [AOR] 1.39; 95% CI 1.25–1.55) and MI (AOR 1.82; 95% CI 1.37 to 2.41), respectively.

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