Use of Both Aspirin and NSAIDs Associated With Incident Heart Failure Risk

Neither NSAID or aspirin use alone was associated with incident heart failure.
Neither NSAID or aspirin use alone was associated with incident heart failure.

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois. MPR's staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — For adults without cardiovascular disease at baseline, using both aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) showed positive associations with incident heart failure, according to research presented at the Scientific Sessions of the American Heart Association, held November 10 to 12.

While aspirin is frequently prescribed for cardioprotective benefits, the use of other NSAIDs has been associated with functional deterioration in patients with pre-existing heart failure, less is known about how these alternative NSAIDs may affect developing incident heart failure.

Researchers in the current study analyzed cohort data from the Multi-Ethnic Study of Atherosclerosis including women and men age 45 to 84 who were free of cardiovascular disease at baseline.

Data included extensive information on medications, risk factors, biomarkers, and cardiac MRI, with more than 10 years of follow-up. Cohort participants were grouped into four categories: no aspirin or NSAID, both aspirin and NSAID, aspirin only, and NSAID only. Hazard ratios for incident heart failure were calculated using Cox regression models. 

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Nineteen-point-eight percent of the 6769 participants (who were 61% non-white, 47% male, and had a mean age 62) were in the aspirin group, 18.3% in the NSAID group, and 5.2% in the both aspirin and NSAID group.

Over a median follow-up period of 10.2 years, 330 participants developed incident heart failure, with the highest percentage in the both aspirin and NSAID group. After adjusting for demographics, risk factors, and lifestyle, neither NSAID or aspirin use alone was associated with incident heart failure, while use of both was associated with increased risk.

Study investigators conclude that “use of both NSAID and [aspirin] was positively associated with incident [heart failure], and remained significant after adjustment for potential confounders. This finding warrants investigation into possible mechanisms for this observed association.”

Disclosures: Several researchers received consulting fees or research grants from Actelion, Amgen, AstraZeneca, Bayer, Boehringer-Ingelheim, Cardiora, Corvia, Eisai, Gilead, Ironwood, Merck, Novartis, Pfizer, Sanofi, Tenax, and/or United Therapeutics.

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Reference

Mostertz WC, Chen H, Delaney JA, Shah SJ, Yeboah J, Bertoni AG. Association of nonsteroidal anti-inflammatory drug use with incident heart failure within the multi-ethnic study of atherosclerosis. Presented at: AHA 2018; November 10-12, 2018; Chicago, Illinois. Abstract Sa1113/1113