Impact of Lifestyle and Socioeconomic Position on the Association Between Non-steroidal Anti-inflammatory Drug Use and Major Adverse Cardiovascular Events: A Case-Crossover Study.
Adult
Humans
Ibuprofen
/ adverse effects
Diclofenac
/ adverse effects
Naproxen
/ adverse effects
Cross-Over Studies
Risk Factors
Anti-Inflammatory Agents, Non-Steroidal
/ adverse effects
Myocardial Infarction
/ chemically induced
Cardiovascular Diseases
/ chemically induced
Life Style
Socioeconomic Factors
Journal
Drug safety
ISSN: 1179-1942
Titre abrégé: Drug Saf
Pays: New Zealand
ID NLM: 9002928
Informations de publication
Date de publication:
06 2023
06 2023
Historique:
accepted:
20
03
2023
medline:
29
5
2023
pubmed:
3
5
2023
entrez:
2
5
2023
Statut:
ppublish
Résumé
It is unknown whether the cardiovascular risks associated with non-steroidal anti-inflammatory drug (NSAID) use differ according to lifestyle and socioeconomic position. We examined the association between NSAID use and major adverse cardiovascular events (MACE) within subgroups defined by lifestyle and socioeconomic position. We conducted a case-crossover study of all adult first-time respondents to the Danish National Health Surveys of 2010, 2013, or 2017, without previous cardiovascular disease, who experienced a MACE from survey completion through 2020. We used a Mantel-Haenszel method to obtain odds ratios (ORs) of the association between NSAID use (ibuprofen, naproxen, or diclofenac) and MACE (myocardial infarction, ischemic stroke, heart failure, or all-cause death). We identified NSAID use and MACE via nationwide Danish health registries. We stratified the analyses by body mass index, smoking status, alcohol consumption, physical activity level, marital status, education, income, and employment. Compared with non-use, the OR of MACE was 1.34 (95% confidence interval: 1.23-1.46) for ibuprofen, 1.48 (1.04-2.43) for naproxen, and 2.18 (1.72-2.78) for diclofenac. When comparing NSAID use with non-use or the individual NSAIDs with each other, we observed no notable heterogeneity in the ORs within subgroups of lifestyle and socioeconomic position for any NSAID. Compared with ibuprofen, diclofenac was associated with increased risk of MACE in several subgroups with high cardiovascular risk, e.g., individuals with overweight (OR 1.52, 1.01-2.39) and smokers (OR 1.54, 0.96-2.46). The relative increase in cardiovascular risk associated with NSAID use was not modified by lifestyle or socioeconomic position.
Identifiants
pubmed: 37131013
doi: 10.1007/s40264-023-01298-0
pii: 10.1007/s40264-023-01298-0
pmc: PMC10219866
doi:
Substances chimiques
Ibuprofen
WK2XYI10QM
Diclofenac
144O8QL0L1
Naproxen
57Y76R9ATQ
Anti-Inflammatory Agents, Non-Steroidal
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
533-543Informations de copyright
© 2023. The Author(s).
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