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Effect of short-term NSAID use on echocardiographic parameters in elderly people: a population-based cohort study
  1. Karen Eline van den Hondel1,
  2. Mark Eijgelsheim1,
  3. Rikje Ruiter1,4,
  4. Jaqueline C M Witteman1,
  5. Albert Hofman1,
  6. Bruno H Ch Stricker1,2,3,4
  1. 1Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
  2. 2Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
  3. 3Department of Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands
  4. 4Drug Safety Unit, Inspectorate for Health Care, The Hague, The Netherlands
  1. Correspondence to Bruno H Ch Stricker, Department of Epidemiology, Erasmus MC, P O Box 2040, 3000 CA Rotterdam, The Netherlands; b.stricker{at}erasmusmc.nl

Abstract

Background Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with an increased risk of heart failure. NSAIDs inhibit the synthesis of renal prostaglandin, which results in a higher total blood volume, cardiac output and preload. The association between recent start of NSAIDs in elderly people and echocardiographic parameters was investigated.

Methods In the Rotterdam Study, a population-based cohort study, the effect of NSAIDs on left ventricular end-systolic dimension, left ventricular end-diastolic dimension, fractional shortening and left ventricular systolic function was studied in all participants for whom an echocardiogram was available (n=5307). NSAID use was categorised as current NSAID use on the date of echocardiography, past use and never used before echocardiography during the study period. Current use was divided into short-term NSAID use (≤14 days) and long-term NSAID use (>14 days). Associations between drug exposure and echocardiographic measurements were assessed using linear and logistic regression analyses.

Results Current NSAID use for <14 days was associated with a significantly higher left ventricular end-systolic dimension (+1.74 mm, 95% CI 0.20 to 3.28), left ventricular end-diastolic dimension (+3.69 mm, 95% CI 1.08 to 6.31) and significantly lower fractional shortening (−6.03%, 95% CI −9.81% to −2.26%) compared with non-users. Current NSAID use for >14 days was associated with a higher left end-diastolic dimension (+1.96 mm, 95% CI 0.82 to 3.11) but there was no change in the other echocardiographic parameters.

Conclusion This study is the first to investigate the association between NSAIDs and echocardiographic parameters and suggests that there is a transient effect of short-term use of NSAIDs on the left ventricular dimension and function of the heart.

  • Non-steroidal anti-inflammatory agents
  • echocardiography
  • elderly
  • heart failure
  • population-based cohort study
  • echocardiography (three-dimensional)
  • old age
  • nsaids
  • epidemiology

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Footnotes

  • See Editorial, p 517

  • Linked articles 209536.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The Rotterdam Study was approved by the medical ethics committee of the Erasmus MC.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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