CP-072 Cardiovascular risk associated with the use of non steroidal anti-inflammatory drugs. Cohort study

Abstract

BackgroundSince the clinical trial VIGOUR, in which the use of rofecoxib was proved to be connected to a larger number of cardiovascular accidents, an increase in cardiovascular diseases connected to the use of non-steroidal anti-inflammatory drugs has been observed.PurposeThis study intends to evaluate cardiovascular impact related to the use of non steroidal anti-inflammatory drugs.Material and methodsA retrospective observational study of a clinical cohort over 5 years was done in which all patients older than 18 years (n = 116 686) were included. The statistical analysis was done estimating the incidence of acute coronary syndrome in relation to exposure time. The risk associated with the consumption of non-steroidal anti-inflammatory drugs was made by Poisson regression adjusting for sex and age.ResultsThe connexion between acute coronary syndrome and the use of anti-inflammatory drugs was positive and significant (RR 3.64; 95% CI 2.94 to 4.52; p < 0.001). The cardiovascular risk was higher for alkanones (RR 18; 95% CI 2.53 to 127; p = 0.004), followed by propionoicos (RR 2.58; 95% CI 2.16 to 3.69; p < 0.001), arylacetic (RR 1.88; 95% CI 1.6 to 2.22; p < 0.001) and finally coxib (RR 1.55; 95% CI 1.25 to 1.92; p < 0.001); in other anti-inflammatories, no increased cardiovascular risk was observed.ConclusionThe use of non steroidal anti-inflammatory drugs has been connected to a higher risk of cardiovascular accidents; these drugs must not be consumed for a long time or at high doses.References and/or AcknowledgementsGarcía Rodríguez LA, González-Pérez A, et al. NSAID use selectively increases the risk of non-fatal myocardial infarction: a systematic review of randomised trials and observational studies. PLoS One 2011;6:e16780Varas-Lorenzo C, Castellsague J, et al. The use of selective cyclooxygenase-2 inhibitors and the risk of acute myocardial infarction in Saskatchewan, Canada. Pharmacoepidemiol Drug Saf 2009;18:1016-25García Rodríguez LA, Tacconelli S, Patrignani P. Role of dose potency in the prediction of risk of myocardial infarction associated with nonsteroidal anti-inflammatory drugs in the general population. J Am Coll Cardiol 2008;11(52):1628-36No conflict of interest.