Non-steroidal anti-inflammatory drugs linked to higher Afib risk

Takeaway

• Nonsteroidal anti-inflammatory drugs (NSAIDs) use was associated with an increased risk for incident atrial fibrillation (Afib).
• The risk was consistent among different NSAIDs (diclofenac, ibuprofen, and naproxen) with the lower risk associated with ibuprofen.

Why this matters

• Finding suggests that physicians should consider the risk of Afib in patients who have been prescribed NSAIDs.

Study design

• Meta-analysis included 8 observational studies (4 case-control and 4 cohort studies) including 14,806,420 after a search across electronic databases.
• Funding: None disclosed.

Key results

• Compared with non-NSAID users, NSAID users were at an increased risk for incident Afib (risk ratio [RR], 1.29; 95% CI, 1.19-1.39; I²=68%).
• Use of NSAIDs was associated with an increased risk for incident Afib among both case-control (RR, 1.37; 95% CI, 1.15-1.63; I²=84%) and cohort (RR, 1.22; 95% CI, 1.14-1.31) studies.
• Subgroup analysis based on specific NSAIDs revealed that Afib risk was highest with naproxen (RR, 1.44; 95% CI, 1.18–1.76), followed by diclofenac (RR, 1.37; 95% CI, 1.10–1.71) and ibuprofen (RR, 1.30; 95% CI, 1.22–1.39)

Limitations

• Heterogeneity among studies.
• Definition for the diagnosis of Afib differed among studies.