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NSAID use might substantially raise atrial fibrillation risk


Current and recent use of non-steroidal anti-inflammatory drugs may be linked to a heightened risk of atrial fibrillation among older adults, according to a large population study in the Netherlands.

Atrial fibrillation has been linked to stroke, heart failure and reduced life expectancy, according to background information in the study, which was published April 8 on the website of BMJ Open. Previously published research has connected the use of NSAIDs to a heightened risk of cardiovascular problems, including myocardial infarction.

Researchers regularly monitored the heart health of 8,423 people taking part in the Rotterdam Study, a population-based study that has been tracking the development of ill health and associated risk factors among adults ages 55 and older since 1990 in one district of Rotterdam, the Netherlands.

New and current cases of atrial fibrillation were diagnosed using electrocardiograms, while details of drugs prescribed to study participants were gathered from pharmacies collaborating on the research project. The average of the study participants was 68.5, and 58% were women.

During the average monitoring period, which spanned just under 13 years, 857 of the 8,423 participants developed atrial fibrillation. Of those, 261 never had used NSAIDs when they were diagnosed, 554 had used NSAIDs in the past and 42 were currently taking the drugs.

Current use was associated with a 76% greater risk of atrial fibrillation than never-use, after accounting for other risk factors such as age, sex and underlying cardiovascular problems.

Similarly NSAID use within the preceding 30 days was linked to an 84% greater risk of atrial fibrillation. While there was a trend for higher doses to be linked to a correspondingly higher risk, this trend was not statistically significant.

NSAIDs may contribute to atrial fibrillation because they inhibit the production of the enzyme cyclo-oxygenase, which may increase blood pressure as a result of fluid retention, the authors suggested.

Alternatively, they said, use of NSAIDs may indicate underlying inflammation, which may increase the risk of atrial fibrillation.

Whatever the explanation, “the underlying mechanism behind this association deserves further attention,” they concluded.



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