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

  • Chokesuwattanaskul R & al.
  • QJM
  • 1 Feb 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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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.