Castelli Gregory, Petrone Ashley, Xiang Jun, Shrader Carl, King Dana
School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA.
Department of Family Medicine, West Virginia University, Morgantown, WV, 26506, USA.
Am J Cardiovasc Drugs. 2017 Jun;17(3):243-249. doi: 10.1007/s40256-016-0212-1.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain, inflammation, and fever in the USA. Unfortunately, NSAIDs have been associated with an increased risk of adverse cardiovascular events, especially among NSAID users with established cardiovascular disease (CVD). In 2005, the Food and Drug Administration (FDA) released an initial warning regarding NSAID use and CVD risk, and recently, in July 2015, released an updated statement strengthening this initial warning. The purpose of this study is to evaluate the rates of NSAID use among patients with CVD following the 2005 FDA warning regarding NSAID use and increased CVD risk.
This was a retrospective, cross-sectional study of participants from the National Health and Nutrition Examination Survey, 2009-2010. Participants' CVD status was determined by self-reported diagnosis. Current use of over the counter (OTC) NSAIDs was defined by self-reported use of ibuprofen or naproxen, and we identified the current use of prescription NSAIDs in the database of prescription medication.
Respondents with CVD were 2.1 times more likely to use OTC NSAIDs or prescription NSAIDs than respondents without CVD. Among CVD patients, respondents with angina and myocardial infarction were 60% more likely to use any form of NSAID, and respondents with congestive heart failure were less likely to use any form of NSAID than those with other forms of CVD.
Our results indicate that there is still a large proportion of CVD patients using NSAIDs. It is now crucial to determine the reasons why prescribers are still prescribing NSAIDs despite the FDA warning.
在美国，非甾体抗炎药（NSAIDs）常用于治疗疼痛、炎症和发热。不幸的是，NSAIDs与不良心血管事件风险增加有关，尤其是在已患有心血管疾病（CVD）的NSAIDs使用者中。2005年，美国食品药品监督管理局（FDA）发布了关于NSAIDs使用与CVD风险的初步警告，最近在2015年7月又发布了一份更新声明，强化了这一初步警告。本研究的目的是评估在2005年FDA发布关于NSAIDs使用及CVD风险增加的警告后，CVD患者中NSAIDs的使用比例。
这是一项对2009 - 2010年美国国家健康与营养检查调查参与者的回顾性横断面研究。参与者的CVD状况通过自我报告的诊断来确定。非处方（OTC）NSAIDs的当前使用情况通过自我报告使用布洛芬或萘普生确定，我们在处方药数据库中确定了处方NSAIDs的当前使用情况。
患有CVD的受访者使用OTC NSAIDs或处方NSAIDs的可能性是非CVD受访者的2.1倍。在CVD患者中，患有心绞痛和心肌梗死的受访者使用任何形式NSAIDs的可能性高出60%，而患有充血性心力衰竭的受访者使用任何形式NSAIDs的可能性低于患有其他形式CVD的受访者。
我们的结果表明，仍有很大比例的CVD患者在使用NSAIDs。尽管有FDA的警告，但确定处方者仍在开具NSAIDs的原因现在至关重要。
