非甾体抗炎药与新发心力衰竭风险：观察性研究的系统评价和荟萃分析
Nonsteroidal Anti-inflammatory Drugs and Risk of Incident Heart Failure: A Systematic Review and Meta-analysis of Observational Studies.
作者信息
Ungprasert Patompong, Srivali Narat, Thongprayoon Charat
机构信息
Division of Rheumatology, Department of Medicine (Ungprasert), Mayo Clinic, Rochester, Minnesota.
Department of Medicine (Ungprasert), Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Clin Cardiol. 2016 Feb;39(2):111-8. doi: 10.1002/clc.22502. Epub 2015 Dec 31.
BACKGROUND
The association between the development of heart failure (HF) and use of nonsteroidal anti-inflammatory drugs (NSAIDs) is not well established.
HYPOTHESIS
Use of NSAIDs may increase the risk of incident HF.
METHODS
We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing risk of incident HF in NSAID users vs nonusers. Pooled risk ratios (RR) and 95% confidence intervals (CI) for all NSAIDs and both subclasses (conventional NSAIDs and highly selective cyclooxygenase-2 inhibitors [COXIBs]) were calculated using a random-effect, generic inverse variance method.
RESULTS
Seven studies with 7,543,805 participants were identified and included in our data analysis. Use of NSAIDs was associated with a significantly higher risk of developing HF, with a pooled RR of 1.17 (95% CI: 1.01-1.36). Subgroup analysis showed a significantly elevated risk among users of conventional NSAIDs (RR: 1.35, 95% CI: 1.15-1.57) but not users of COXIBs (RR: 1.03, 95% CI: 0.92-1.16).
CONCLUSIONS
A significantly elevated risk of incident HF was observed among users of NSAIDs.
背景
心力衰竭（HF）的发生与非甾体抗炎药（NSAIDs）的使用之间的关联尚未明确。
假设
使用NSAIDs可能会增加发生HF的风险。
方法
我们对观察性研究进行了系统评价和荟萃分析，这些研究报告了比较NSAIDs使用者与非使用者发生HF风险的比值比、相对风险、风险比或标准化发病率比。使用随机效应、通用逆方差法计算所有NSAIDs以及两个亚类（传统NSAIDs和高选择性环氧化酶-2抑制剂[COXIBs]）的合并风险比（RR）和95%置信区间（CI）。
结果
共识别出7项研究，涉及7,543,805名参与者，并纳入我们的数据分析。使用NSAIDs与发生HF的风险显著升高相关，合并RR为1.17（95%CI：1.01-1.36）。亚组分析显示，传统NSAIDs使用者的风险显著升高（RR：1.35，95%CI：1.15-1.57），但COXIBs使用者的风险未升高（RR：1.03，95%CI：0.92-1.16）。
结论
观察到NSAIDs使用者发生HF的风险显著升高。
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