Harmful Effects of NSAIDs among Patients with Hypertension and Coronary Artery Disease
American Journal of Medicine, 06/23/2011
Clinical Article
Bavry AA et al. – Among hypertensive patients with coronary artery disease, chronic self–reported use of NSAIDs was associated with an increased risk of adverse events during long–term follow–up.
Methods- This was a post hoc analysis from the INternational VErapamil Trandolapril STudy (INVEST), which enrolled patients with hypertension and coronary artery disease.
- At each visit, patients were asked by the local site investigator if they were currently taking NSAIDs.
- Patients who reported NSAID use at every visit were defined as chronic NSAID users, while all others (occasional or never users) were defined as nonchronic NSAID users.
- The primary composite outcome was all–cause death, nonfatal myocardial infarction, or nonfatal stroke.
- Cox regression was used to construct a multivariate analysis for the primary outcome.
- There were 882 chronic NSAID users and 21,694 nonchronic NSAID users (n = 14,408 for never users and n=7286 for intermittent users).
- At a mean follow–up of 2.7 years, the primary outcome occurred at a rate of 4.4 events per 100 patient–years in the chronic NSAID group, versus 3.7 events per 100 patient–years in the nonchronic NSAID group (adjusted hazard ratio [HR] 1.47; 95% confidence interval [CI], 1.19–1.82; P=.0003).
- This was due to an increase in cardiovascular mortality (adjusted HR 2.26; 95% CI, 1.70–3.01; P<.0001).
