Objective of the study was to disentangle the role of nonsteroidal anti-inflammatory drugs ( NSAIDs ) in the increased risk of cardiovascular disease ( CVD ) among osteoarthritis patients.
This longitudinal study was based on linked health administrative data ( HAD ) from British Columbia, Canada.
From a population‐based cohort of 720,055 British Columbians, researchers matched on age and sex to assemble 7,743 osteoarthritis patients and 23,229 non‐osteoarthritis controls.
Researchers have used multivariable Cox proportional hazards models to estimate the risk of developing incident cardiovascular disease ( primary outcome ) as well as ischemic heart disease ( IHD ), congestive heart failure ( CHF ) and stroke ( secondary outcomes ).
People with osteoarthritis had a higher risk of developing cardiovascular disease compared to people without osteoarthritis.
After adjusting for SES ( socioeconomic status ), BMI ( body mass index ), hypertension, diabetes, hyperlipidemia, COPD ( chronic obstructive pulmonary disease ), and Romano comorbidity score, adjusted hazard ratio [ HR ] ( 95% CI ) was 1.23 ( 1.17, 1.28 ).
Adjusted hazard ratio ( 95% CI ) was 1.42 ( 1.33, 1.51 ), 1.17 ( 1.10, 1.26 ), 1.14 ( 1.07, 1.22 ) for congestive heart failure, ischemic heart disease and stroke, respectively.
Approximately 41% of the total effect of osteoarthritis on increased CVD risk was mediated through NSAID.
Among the secondary outcomes, the proportion mediated through NSAID was 23%, 56% and 64% for congestive heart failure, ischemic heart disease and stroke, respectively.
In conclusion, findings of this first study to evaluate NSAID's mediating role in osteoarthritis ‐ cardiovascular disease relationship suggest that NSAID use substantially contributes to the osteoarthritis ‐ cardiovascular disease association. ( Xagena )
Atiquzzaman M et al, Arthritis & Rheumatology 2019; doi: 10.1002/art.41027