Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used to relieve pain, inflammation, and high temperature due to fever. But their use has been routinely associated with adverse cardiovascular events. This study aims to examine the cardiovascular safety of NSAIDs by estimating the risk of heart failure.

This nested case-control study included a total of 92,163 hospital admissions for heart failure, along with 8,246,403 controls. The primary outcome of the study was the risk of heart failure associated with the use of 27 individual NSAIDs. The researchers assessed multivariable conditional logistic regression models and dose-response relation.

The findings suggested that the use of any NSAID was associated with a 19% increase in the risk of hospital admission for heart failure (adjusted odds 1.19). It was also discovered that the risk of admission for heart failure was higher for seven traditional NSAIDs and two COX2 inhibitors; the odds ratios ranged from 1.16 to 1.83. The risk of heart failure doubled for the use of the following doses at very high doses: indomethacin, piroxicam, diclofenac, etoricoxib, and rofecoxib.

The research concluded that the risk of heart failure varied between different NSAIDs, with the risk being the highest for traditional NSAIDs and COX2 inhibitors.

Ref: https://www.bmj.com/content/354/bmj.i4857