Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht 3508 TB, the Netherlands.
Department of Pharmacology, Faculty of Medicine, Lambung Mangkurat University, Banjarmasin, Indonesia.
Europace. 2019 Jan 1;21(1):99-105. doi: 10.1093/europace/euy180.
Non-steroidal anti-inflammatory drugs (NSAIDs), particularly selective COX-2 inhibitors, are associated with an increased risk of cardiovascular adverse events. However, the association between these drugs and out-of-hospital cardiac arrest with electrocardiogram-documented ventricular tachycardia/ventricular fibrillation (VT/VF-OHCA) has not been studied yet. This study was aimed to evaluate the association between the use of selective COX-2 inhibitors or conventional NSAIDs and VT/VF-OHCA compared with non-use.
A case-control study was conducted among 2483 cases with VT/VF-OHCA from the AmsteRdam REsuscitation STudies (ARREST) registry, an ongoing Dutch registry of OHCA, and 10 441 non-VT/VF-OHCA-controls from the Dutch PHARMO Database Network, containing drug dispensing records of community pharmacies, over the period July 2005-December 2011. Up to five controls were matched for age and sex to one case at the date of VT/VF-OHCA (index date). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by conditional logistic regression analysis. Of the cases, 0.5% was currently exposed at the index date to selective COX-2 inhibitors and 2.5% to conventional NSAIDs. Neither current use of selective COX-2 inhibitors nor conventional NSAIDs were associated with an increased risk of VT/VF-OHCA (adjusted OR 1.11, 95% CI: 0.79-1.56 and adjusted OR 0.97, 95% CI: 0.86-1.10, respectively) compared with non-use. Stratification for VT/VF-OHCA with presence/absence of acute myocardial infarction did not change these results.
Exposure to selective COX-2 inhibitors or conventional NSAIDs was not associated with an increased risk of VT/VF-OHCA compared with non-use.
非甾体抗炎药（NSAIDs），特别是选择性环氧化酶-2 抑制剂，与心血管不良事件的风险增加相关。然而，这些药物与心电图记录的室性心动过速/心室颤动（VT/VF-OHCA）的院外心脏骤停之间的关联尚未得到研究。本研究旨在评估与非使用者相比，使用选择性 COX-2 抑制剂或传统 NSAIDs 与 VT/VF-OHCA 的相关性。
一项病例对照研究在 AmsteRdam REsuscitation STudies（ARREST）登记处的 2483 例 VT/VF-OHCA 病例中进行，该登记处是一项正在进行的荷兰 OHCA 登记处，以及来自荷兰 PHARMO 数据库网络的 10441 例非 VT/VF-OHCA 对照，该网络包含社区药店的药物配药记录，研究时间为 2005 年 7 月至 2011 年 12 月。在 VT/VF-OHCA 发生日期（索引日期），将每个病例与年龄和性别相匹配的最多 5 个对照者匹配。通过条件逻辑回归分析计算比值比（OR）和 95%置信区间（CI）。在病例中，0.5%的病例在索引日期当前暴露于选择性 COX-2 抑制剂，2.5%的病例当前暴露于传统 NSAIDs。与非使用者相比，当前使用选择性 COX-2 抑制剂或传统 NSAIDs 均与 VT/VF-OHCA 的风险增加无关（调整后的 OR 1.11，95%CI：0.79-1.56 和调整后的 OR 0.97，95%CI：0.86-1.10）。VT/VF-OHCA 伴有或不伴有急性心肌梗死的分层并未改变这些结果。
与非使用者相比，暴露于选择性 COX-2 抑制剂或传统 NSAIDs 与 VT/VF-OHCA 的风险增加无关。
