Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.
The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
Eur Heart J Cardiovasc Pharmacother. 2017 Apr 1;3(2):100-107. doi: 10.1093/ehjcvp/pvw041.
Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been associated with increased cardiovascular risk. Nonetheless, it remains unknown whether use of NSAIDs is associated with out-of-hospital cardiac arrest (OHCA).
From the nationwide Danish Cardiac Arrest Registry, all persons with OHCA during 2001-10 were identified. NSAID use 30 days before OHCA was categorized as follows: diclofenac, naproxen, ibuprofen, rofecoxib, celecoxib, and other. Risk of OHCA associated with use of NSAIDs was analysed by conditional logistic regression in case-time-control models matching four controls on sex and age per case to account for variation in drug utilization over time. We identified 28 947 persons with OHCA of whom 3376 were treated with an NSAID up to 30 days before OHCA. Ibuprofen and diclofenac were the most commonly used NSAIDs and represented 51.0% and 21.8% of total NSAID use, respectively. Use of diclofenac (odds ratio [OR], 1.50 [95% confidence interval (CI) 1.23-1.82]) and ibuprofen [OR, 1.31 (95% CI 1.14-1.51)] was associated with a significantly increased risk of OHCA. Use of naproxen [OR, 1.29 (95% CI 0.77-2.16)], celecoxib [OR, 1.13 (95% CI 0.74-1.70)], and rofecoxib (OR, 1.28 [95% CI 0.74-1.70)] was not significantly associated with increased risk of OHCA; however, these groups were characterized by few events.
Use of non-selective NSAIDs was associated with an increased early risk of OHCA. The result was driven by an increased risk of OHCA in ibuprofen and diclofenac users.
非甾体抗炎药（NSAIDs）被广泛使用，并与心血管风险增加有关。尽管如此，目前仍不清楚 NSAIDs 的使用是否与院外心脏骤停（OHCA）有关。
从全国丹麦心脏骤停登记处确定了 2001 年至 2010 年期间所有 OHCA 患者。将 OHCA 前 30 天内使用 NSAIDs 分为以下几类：双氯芬酸、萘普生、布洛芬、罗非昔布、塞来昔布和其他。使用条件逻辑回归在病例时间对照模型中分析 NSAIDs 使用与 OHCA 风险的关系，该模型按性别和年龄匹配每个病例的 4 个对照，以解释随时间变化的药物利用差异。我们确定了 28947 名 OHCA 患者，其中 3376 名患者在 OHCA 前 30 天内使用 NSAIDs。布洛芬和双氯芬酸是最常用的 NSAIDs，分别占 NSAIDs 总使用量的 51.0%和 21.8%。使用双氯芬酸（比值比 [OR]，1.50 [95%置信区间（CI）1.23-1.82]）和布洛芬（OR，1.31 [95% CI 1.14-1.51]）与 OHCA 风险显著增加相关。使用萘普生（OR，1.29 [95% CI 0.77-2.16]）、塞来昔布（OR，1.13 [95% CI 0.74-1.70]）和罗非昔布（OR，1.28 [95% CI 0.74-1.70]）与 OHCA 风险增加无显著相关性；然而，这些组的事件数量较少。
非选择性 NSAIDs 的使用与 OHCA 的早期风险增加有关。这一结果是由布洛芬和双氯芬酸使用者的 OHCA 风险增加驱动的。
