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Current, recent NSAID use may increase AF risk
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The use of nonsteroidal anti-inflammatory drugs was linked to an increased risk for atrial fibrillation in a recent study.
Researchers evaluated data from 8,423 participants in the Rotterdam Study (RS), a population-based prospective cohort study designed to evaluate risk factors for and onset of disease among older adults. The analysis included a combination of participants from RS cohort 1 (RS-I) with a baseline visit between 1990 and 1993, and those from RS cohort 2 (RS-II), with a baseline visit from 2000 to 2001. The mean age of the participants was 68.5 years, and 58.6% were women.
At baseline, researchers conducted at-home interviews with participants and performed physical examinations at the research center, including a 12-lead resting ECG. Participants free of AF during the baseline ECG evaluation were followed until incident AF diagnosis, death, loss to follow-up or study conclusion on Jan. 1, 2009.
During a mean follow-up of 12.9 years, 857 participants developed AF. Among these patients, 261 reported never using NSAIDs, 554 reported prior use and 42 indicated currently using NSAIDs at AF diagnosis. Compared with never having used NSAIDs, current use for 15 to 30 days was correlated with an increased risk for AF (HR=1.76; 95% CI, 1.07-2.88). After adjustment for age, sex and other possible confounders, recent prior use (discontinuation within the past 30 days) also was linked to elevated risk for AF vs. never-use (HR=1.84; 95% CI, 1.34-2.51).
Sensitivity analyses adjusting for left ventricular end-diastolic dimension indicated an increased risk for AF with increasing dimension (HR=1.17; 95% CI, 1.01-1.35 per SD increment) after adjustment for confounders. However, additional adjustment for LV end-diastolic dimension did not alter the association between current NSAID use and AF risk (HR=3.21; 95% CI, 1.21-8.48) vs. never-use.
“Our results suggest that NSAID use is associated with a higher risk of AF,” the researchers concluded, adding that these findings support the results from other, previously published studies, while also indicating that the risk increase follows shortly after beginning NSAID treatment and may reduce with time. “… Current use and recent past use were especially associated with a higher risk of AF, adjusted for age, sex and CV risk factors. The underlying mechanism behind this association deserves further attention.”
Disclosure: The researchers report no relevant financial disclosures.
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