Eika Jakob Kjølby, Bonnesen Kasper, Pedersen Lars, Ehrenstein Vera, Sørensen Henrik Toft, Schmidt Morten
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Clin Epidemiol. 2024 Nov 14;16:793-802. doi: 10.2147/CLEP.S483553. eCollection 2024.
Ibuprofen is used to treat acute pericarditis, but high-dose ibuprofen has also been associated with increased cardiovascular risks. We examined the cardiovascular safety of using ibuprofen for acute pericarditis.
A Danish nationwide, population-based cohort study including patients 18 years with first-time acute pericarditis (n=12,381) during 1996-2020 was conducted. Ibuprofen use was modelled in two ways: First, we considered patients exposed based on the tablet strength of their first ibuprofen filling (a proxy for an analysis). Second, we considered patients exposed in a time-varying manner (a proxy for an analysis). The primary outcome of major adverse cardiovascular events (MACE) was a composite of myocardial infarction, ischemic stroke, congestive heart failure, and cardiovascular death.
In the analysis, the 1-year risk of MACE was 1.37% (95% confidence interval [CI]: 1.03-1.79) for ibuprofen initiators and 4.32% (95% CI: 3.89-4.78) for non-initiators. Compared with non-initiators within 1-year follow-up, the adjusted hazard ratio for MACE was 0.75 (95% CI: 0.67-0.85) for initiators overall, 0.38 (95% CI: 0.28-0.52) for initiators of >400 mg tablets, and 0.87 (95% CI: 0.76-0.99) for initiators of ≤400 mg tablets. In the analysis, compared with no use, the hazard ratio associated with ibuprofen use was 0.69 (95% CI: 0.54-0.89) for MACE, 0.82 (95% CI: 0.54-1.26) for myocardial infarction, 0.74 (95% CI: 0.45-1.22) for ischemic stroke, 0.67 (95% CI: 0.47-0.96) for congestive heart failure, and 0.60 (95% CI: 0.31-1.17) for cardiovascular death.
Ibuprofen use for acute pericarditis was not associated with increased cardiovascular risks, supporting its safety in current practice.
布洛芬用于治疗急性心包炎，但高剂量布洛芬也与心血管风险增加有关。我们研究了使用布洛芬治疗急性心包炎的心血管安全性。
开展了一项丹麦全国性的基于人群的队列研究，纳入1996年至2020年期间首次发生急性心包炎的18岁及以上患者（n = 12381）。布洛芬的使用通过两种方式进行建模：第一，我们根据患者首次布洛芬配药的片剂强度（一种替代分析方法）来考虑暴露患者。第二，我们以随时间变化的方式考虑暴露患者（一种替代分析方法）。主要不良心血管事件（MACE）的主要结局是心肌梗死、缺血性中风、充血性心力衰竭和心血管死亡的综合结果。
在第一种分析中，布洛芬起始使用者1年的MACE风险为1.37%（95%置信区间[CI]：1.03 - 1.79），非起始使用者为4.32%（95% CI：3.89 - 4.78）。在1年随访期间，与非起始使用者相比，MACE的调整后风险比总体起始使用者为0.75（95% CI：
0.67 - 0.85），>400 mg片剂起始使用者为0.38（95% CI：0.28 - 0.52），≤400 mg片剂起始使用者为0.87（95% CI：0.76 - 0.99）。在第二种分析中，与未使用相比，布洛芬使用与MACE的风险比为0.69（95% CI：0.54 - 0.89），心肌梗死为0.82（95% CI：0.54 - 1.26），缺血性中风为0.74（95% CI：0.45 - 1.22），充血性心力衰竭为0.67（95% CI：0.47 - 0.96），心血管死亡为0.60（95% CI：0.31 - 1.17）。
使用布洛芬治疗急性心包炎与心血管风险增加无关，这支持了其在当前实践中的安全性。
