NSAID Dose Associated With Risk of CVD Among Patients With axSpA

In a real-world cohort of almost 20,000 patients with axial spondyloarthritis (axSpA), higher doses of nonsteroidal anti-inflammatory drugs (NSAID) were associated with increased risks of ischemic heart disease, stroke, and congestive heart failure, according to a paper published in Annals of Rheumatic Diseases.

The researchers used the Korean National Health Insurance database to identify patients who had been newly diagnosed with axSpA and had no history of cardiovascular disease during the years 2010-2018. The primary outcome comprised ischemic heart disease, stroke, or congestive heart failure.

Of the 19,775 patients, the majority—19,706—received NSAID treatment. The mean age of these patients was 36 years; 75% were men. During the 98,290 person-year follow-up period, 1157 cases of ischemic heart disease, 301 cases of stroke, and 613 cases of congestive heart failure occurred.

After adjusting for confounders (adjusted HR (aHR) 1.10; 95% CI 1.08 to 1.13), increasingly higher doses of NSAIDs were associated with incident ischemic heart disease (aHR 1.08; 95% CI 1.05 to 1.11), stroke (aHR 1.09; 95% CI 1.04 to 1.15), and congestive heart failure (aHR 1.12; 95% CI 1.08 to 1.16).

“The association between NSAID dose and higher CVD risk was consistent in different subgroups,” the authors noted.

Reference:

Kim JW, Yoon JS, Park S, Kim H, Lee JS, Choe JY. Risk of cardiovascular disease with high-dose versus low-dose use of non-steroidal anti-inflammatory drugs in ankylosing spondylitis. Ann Rheum Dis. 2024;83:1028-1033.