NSAID use linked to relapse but not first occurrence of heart failure

מתוך medicontext.co.il
NEW YORK (Reuters Health) – Among patients with a history of heart failure, those who use nonsteroidal anti-inflammatory drugs (NSAIDs) are nearly 10 times more likely to experience a disease relapse than nonusers, according to a recent report. NSAID use, however, is not a risk factor for incident heart failure.

Dr. Bruno H. Ch. Stricker, from Erasmus Medical Center Rotterdam in the Netherlands, and colleagues evaluated the link between NSAID use and heart failure by assessing the outcomes of 7277 adults who participated in a population-based study. The group included 345 subjects in whom heart failure occurred during an average followup of 6 years.

After adjusting for age, sex, and concomitant medication use, the researchers found that incident heart failure was no more likely in NSAID users than nonusers (relative risk ,1.1). In contrast, the adjusted relative risk for relapse after a diagnosis of congestive heart failure was 9.9 in NSAID users compared with nonusers.

Previous reports have suggested that NSAID use leads to the onset of heart failure, the investigators note. However, in most of these reports, the patients had pre-existing cardiovascular diseases that may have predisposed them to heart failure development. In addition, first hospitalization for heart failure, a parameter evaluated in one study, does not necessarily reflect disease onset.

The current findings do not support a link between NSAID use and incident heart failure. Relapse heart failure, however, is strongly linked to NSAID use, suggesting that these drugs "should be prescribed with caution to patients with prevalent heart failure."

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