PMID- 27682515
OWN - NLM
STAT- MEDLINE
DCOM- 20180226
LR  - 20180226
IS  - 1756-1833 (Electronic)
IS  - 0959-8138 (Linking)
VI  - 354
DP  - 2016 Sep 28
TI  - Non-steroidal anti-inflammatory drugs and risk of heart failure in four European 
      countries: nested case-control study.
PG  - i4857
LID - 10.1136/bmj.i4857 [doi]
AB  - OBJECTIVES: To investigate the cardiovascular safety of non-steroidal
      anti-inflammatory drugs (NSAIDs) and estimate the risk of hospital admission for 
      heart failure with use of individual NSAIDs. DESIGN: Nested case-control study.
      SETTING: Five population based healthcare databases from four European countries 
      (the Netherlands, Italy, Germany, and the United Kingdom). PARTICIPANTS: Adult
      individuals (age >/=18 years) who started NSAID treatment in 2000-10. Overall, 92
      163 hospital admissions for heart failure were identified and matched with 8 246 
      403 controls (matched via risk set sampling according to age, sex, year of cohort
      entry). MAIN OUTCOME MEASURE: Association between risk of hospital admission for 
      heart failure and use of 27 individual NSAIDs, including 23 traditional NSAIDs
      and four selective COX 2 inhibitors. Associations were assessed by multivariable 
      conditional logistic regression models. The dose-response relation between NSAID 
      use and heart failure risk was also assessed. RESULTS: Current use of any NSAID
      (use in preceding 14 days) was found to be associated with a 19% increase of risk
      of hospital admission for heart failure (adjusted odds ratio 1.19; 95% confidence
      interval 1.17 to 1.22), compared with past use of any NSAIDs (use >183 days in
      the past). Risk of admission for heart failure increased for seven traditional
      NSAIDs (diclofenac, ibuprofen, indomethacin, ketorolac, naproxen, nimesulide, and
      piroxicam) and two COX 2 inhibitors (etoricoxib and rofecoxib). Odds ratios
      ranged from 1.16 (95% confidence interval 1.07 to 1.27) for naproxen to 1.83
      (1.66 to 2.02) for ketorolac. Risk of heart failure doubled for diclofenac,
      etoricoxib, indomethacin, piroxicam, and rofecoxib used at very high doses (>/=2 
      defined daily dose equivalents), although some confidence intervals were wide.
      Even medium doses (0.9-1.2 defined daily dose equivalents) of indomethacin and
      etoricoxib were associated with increased risk. There was no evidence that
      celecoxib increased the risk of admission for heart failure at commonly used
      doses. CONCLUSIONS: The risk of hospital admission for heart failure associated
      with current use of NSAIDs appears to vary between individual NSAIDs, and this
      effect is dose dependent. This risk is associated with the use of a large number 
      of individual NSAIDs reported by this study, which could help to inform both
      clinicians and health regulators.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not
      already granted under a licence) please go to
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Arfe, Andrea
AU  - Arfe A
AD  - Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics 
      and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy.
FAU - Scotti, Lorenza
AU  - Scotti L
AD  - Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics 
      and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy.
FAU - Varas-Lorenzo, Cristina
AU  - Varas-Lorenzo C
AD  - RTI Health Solutions, Barcelona, Spain.
FAU - Nicotra, Federica
AU  - Nicotra F
AD  - Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics 
      and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy.
FAU - Zambon, Antonella
AU  - Zambon A
AD  - Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics 
      and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy.
FAU - Kollhorst, Bianca
AU  - Kollhorst B
AD  - Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany.
FAU - Schink, Tania
AU  - Schink T
AD  - Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany.
FAU - Garbe, Edeltraut
AU  - Garbe E
AD  - Leibniz Institute of Prevention Research and Epidemiology, Bremen, Germany.
FAU - Herings, Ron
AU  - Herings R
AD  - PHARMO Institute, Utrecht, Netherlands.
FAU - Straatman, Huub
AU  - Straatman H
AD  - PHARMO Institute, Utrecht, Netherlands.
FAU - Schade, Rene
AU  - Schade R
AD  - Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Villa, Marco
AU  - Villa M
AD  - Local Health Authority ASL Cremona, Cremona, Italy.
FAU - Lucchi, Silvia
AU  - Lucchi S
AD  - Local Health Authority ASL Cremona, Cremona, Italy.
FAU - Valkhoff, Vera
AU  - Valkhoff V
AD  - Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Romio, Silvana
AU  - Romio S
AD  - Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Thiessard, Frantz
AU  - Thiessard F
AD  - University of Bordeaux Segalen, Bordeaux, France.
FAU - Schuemie, Martijn
AU  - Schuemie M
AD  - Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Pariente, Antoine
AU  - Pariente A
AD  - University of Bordeaux Segalen, Bordeaux, France.
FAU - Sturkenboom, Miriam
AU  - Sturkenboom M
AD  - Department of Medical Informatics, Erasmus University Medical Centre, Rotterdam, 
      Netherlands.
FAU - Corrao, Giovanni
AU  - Corrao G
AD  - Unit of Biostatistics, Epidemiology, and Public Health, Department of Statistics 
      and Quantitative Methods, University of Milano-Bicocca, 20126 Milan, Italy
      giovanni.corrao@unimib.it.
CN  - Safety of Non-steroidal Anti-inflammatory Drugs (SOS) Project Consortium
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20160928
PL  - England
TA  - BMJ
JT  - BMJ (Clinical research ed.)
JID - 8900488
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
SB  - AIM
SB  - IM
CIN - Ann Intern Med. 2017 Feb 21;166(4):JC23. PMID: 28241296
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
MH  - Case-Control Studies
MH  - Databases, Factual
MH  - Female
MH  - Germany
MH  - Heart Failure/*chemically induced/epidemiology
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Italy
MH  - Logistic Models
MH  - Male
MH  - Netherlands
MH  - Risk Factors
MH  - United Kingdom
EDAT- 2016/09/30 06:00
MHDA- 2018/02/27 06:00
CRDT- 2016/09/30 06:00
PHST- 2016/09/30 06:00 [entrez]
PHST- 2016/09/30 06:00 [pubmed]
PHST- 2018/02/27 06:00 [medline]
PST - epublish
SO  - BMJ. 2016 Sep 28;354:i4857.