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- Title
Comparative Risks of Nonsteroidal Anti‐inflammatory Drugs on Cardiovascular Diseases: A Population‐Based Cohort Study.
- Authors
Wan, Eric Yuk Fai; Yu, Esther Yee Tak; Chan, Linda; Mok, Anna Hoi Ying; Wang, Yuan; Chan, Esther Wai Yin; Wong, Ian Chi Kei; Lam, Cindy Lo Kuen
- Abstract
Through examining the incidence of cardiovascular diseases (CVDs) among nonsteroidal anti‐inflammatory drug (NSAID) users and nonusers, this study aims to compare the risks contributed by different NSAIDs in a Chinese population. The retrospective cohort including 4 298 368 adults without CVD from electronic health records between 2008 and 2017 in Hong Kong was adopted. A total of 4.5% of individuals received NSAIDs including celecoxib, etoricoxib, diclofenac, ibuprofen, indomethacin, mefenamic acid, or naproxen for ≥4 consecutive weeks at baseline. Cox regression, including NSAID use as a time‐dependent covariate and adjusted with patient's characteristics, was conducted to examine the association between NSAID exposure and incident CVD. After a median follow‐up of 6.9 years (30 million person‐years), a total of 258 601 cases of incident CVD was recorded. NSAID use was shown to be associated with a significantly higher risk of CVD (hazard ratio [HR], 1.32 [95%CI, 1.28–1.37]) compared to non‐NSAID use. Similar results in coronary heart disease (HR, 1.37 [95%CI, 1.31–1.43]), stroke (HR, 1.27 [95%CI, 1.21–1.33]), and heart failure (HR, 1.25 [95%CI, 1.16–1.34]) were obtained. Overall, similar CVD risk was observed across users of NSAIDs except for etoricoxib, which showed a higher risk (HR, 2.01 [95%CI, 1.63–2.48]). Considering that a higher CVD risk was consistently displayed among NSAID users, NSAIDs should be used cautiously, and the usage of etoricoxib in the Chinese population should be reviewed.
- Subjects
HONG Kong (China); CHINA; HEART failure risk factors; STROKE risk factors; CYCLOOXYGENASE 2; CONFIDENCE intervals; NONSTEROIDAL anti-inflammatory agents; CARDIOVASCULAR diseases; RETROSPECTIVE studies; RISK assessment; RESEARCH funding; ELECTRONIC health records; LONGITUDINAL method; PHARMACODYNAMICS
- Publication
Journal of Clinical Pharmacology, 2023, Vol 63, Issue 1, p126
- ISSN
0091-2700
- Publication type
Article
- DOI
10.1002/jcph.2142