NSAIDs linked to increased long-term risk for chronic AF
MedWire News: Researchers suggest that patients who use non-steroidal anti-inflammatory drugs (NSAIDs) may have an increased risk for chronic but not paroxysmal atrial fibrillation (AF), particularly if they require treatment for more than 1 year.
"However, the association of increased risk for AF with the use of NSAIDs does not imply a cause-and-effect relationship. Indeed, a likely explanation for our findings is the existence of an underlying inflammatory condition, increasing the risk for AF on the one hand and prompting the use of NSAIDs on the other," comment Raffaele De Caterina (G d'Annunzio University, Chieti, Italy) and team.
They add: "We also confirmed previous findings regarding the association of the use of steroidal anti-inflammatory drugs (SAIDs)."
The researchers analysed SAID and NSAID usage among 1035 patients with incident chronic AF (persisting for >1 week) and 525 patients with paroxysmal AF. To estimate the general risk for first-time chronic and paroxysmal AF among patients using NSAIDS, the team also sampled two groups of 5000 controls at random.
As reported in the Archives of Internal Medicine, Caterina et al found a 1.44-fold increase in chronic AF risk among patients taking NSAIDs at the time of the study, defined as current use, compared with controls.
Treatment duration of more than 1 year further increased the risk for chronic AF among current NSAID users to 1.80-fold, compared with controls.
The researchers also noted that size of daily NSAID dose and the presence of heart failure did not influence chronic AF risk.
No association was found between NSAID use and risk for paroxysmal AF.
Of note, the team observed a 2.49- and 1.51-fold increase in risk for chronic AF among patients currently and recently (stopped taking SAIDs 1 to 6 months before study started) using SAIDs, respectively, compared with controls.
Caterina and colleagues hypothesize that their findings may be explained by "underlying atrial fibrosis, caused by inflammation - for the presence of which the use of anti-inflammatory agents is a marker."
However they advise that "future studies on the association of SAIDs or NSAIDs with AF should ideally include... inflammatory markers, which would help to make the association more biologically plausible."
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By Lauretta Ihonor