THU0125 The Cardiovascular Hazard of NSAIDS in Daily Practice: Prospective Analysis of the ACT-CVD Cohort. (10th June 2014)

• Record Type: Journal Article
• Authors: Meek, I.; Vonkeman, H.; van de Laar, M.
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Supplement 2(2014)
• Page Start: 221
• Page End: 221
• Publication Date: 2014-06-10
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2014-eular.5264
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: The use of NSAIDs is associated with increased cardiovascular (CV) events and death. The NSAID associated CV hazard of different NSIADs may differ: recently it was found highest in diclofenac, and naproxen was found least harmful. 1 Most studies on NSAID associated CV risk were done in clinical trial populations, which generally are highly selected. Objectives: to study the cardiovascular (CV) hazard of NSAID treatment in unselected patients, including elderly patients and patients with comorbidities and comedication. Methods: prospective analysis of 3-year data of the Arthritis Center Twente CardioVascular Disease (ACT-CVD) cohort evaluating the association between continuous use of different non-steroidal anti-inflammatory drugs (NSAIDs; naproxen, diclofenac, ibuprofen, meloxicam or COXIB (etoricoxib or celecoxib)) and the occurrence of first CV events in rheumatoid arthritis (RA) and osteoarthritis (OA). The ACT-CVD cohort contains data of unselected patients with new or longstanding rheumatologic diagnoses, and thus represents a daily clinical rheumatology population. COX-regression analysis was adjusted for baseline estimated 10-year CV risk and intermittent NSAID usage. Results: Of 686 patients, 46, 37/552 non-NSAID and 9/134 NSAID users, had experienced a first CV event after a median follow up of 36 months. COX regression analysis showed a significant association between baseline continuous use of ibuprofen (HR 3.59, 95%CI 1.08-11.93) or COXIB (HR 4.86, 95%CI 1.47-16.11) and the occurrence of major CV events. Conclusions: in an unselected population of RA and OA patients the tNSAID ibuprofen and COXIBs were associated with a significant increase in CV event risk after only 3 years follow up. References: Coxib and traditional NSAID Trialist's Collaboration. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 2013. Disclosure of Interest: : None declared DOI: 10.1136/annrheumdis-2014-eular.5264