NSAIDS Diclofenac and Ibuprofen Associated with Increased Risk of Cardiac Arrest

MedicalResearch.com Interview with:

Kathrine Bach Søndergaard MD, Research Fellow Gentofte University Hospital Department of Cardiology Hellerup

Dr. Søndergaard

Kathrine Bach Søndergaard MD, Research Fellow
Gentofte University Hospital
Department of Cardiology

MedicalResearch.com: What is the background for this study?

Response: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have in previous studies been associated with an increased risk of cardiovascular adverse events, such as myocardial infarction and heart failure. Cardiac arrest is the ultimate adverse event; however, no research exists of the association between cardiac arrest and use of NSAIDs, which we aimed to assess in this study.

MedicalResearch.com: What are the main findings?

Response: We identified all out-of-hospital cardiac arrests in Denmark from 2001 through 2010. The association between NSAIDs and cardiac arrest was analyzed in case-time-control models where each patient served as both case and control in two different time-windows. Thus we identified exposure to NSAIDs 30 days before cardiac arrest (case period) and compared it with exposure in a preceding 30-day period (control period). A major advantage of the case-time-control method is the elimination of cofounding from characteristics that remain stable over time, such as sex, age and chronic comorbidities. Altogether, we included 28,947 cardiac arrests. Of those 3,376 were treated with an NSAID up to 30 days before cardiac arrest. Ibuprofen and diclofenac were the most commonly used NSAIDs and represented 51.0% and 21.8% of total NSAID use, respectively. We observed that use of any NSAID was associated with an increased risk of cardiac arrest of 31%. Ibuprofen and diclofenac were associated with an increased risk of 31% and 50%, respectively, whereas naproxen, celecoxib and rofecoxib were without significant association to cardiac arrest, probably due to few events.

MedicalResearch.com: What should readers take away from your report?

Response: Diclofenac and ibuprofen were both significantly associated with an increased risk of cardiac arrest. They are some of the most commonly used drugs and some of them are available over-the-counter. Our findings add to the growing evidence of NSAIDs not being harmless, which should be considered, when initiating treatment with NSAIDs, particularly in patients with cardiovascular diseases or several cardiovascular risk factors.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: As lots of people continue to use NSAIDs, further research regarding NSAIDs adverse events is warranted. 

No disclosures

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Kathrine B. Sondergaard, Peter Weeke, Mads Wissenberg, Anne-Marie Schjerning Olsen, Emil L. Fosbol, Freddy K. Lippert, Christian Torp-Pedersen, Gunnar H. Gislason, Fredrik Folke
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: https://doi.org/10.1093/ehjcvp/pvw041

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Last Updated on March 20, 2017 by Marie Benz MD FAAD