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Rates of Nonsteroidal Anti-Inflammatory Drug Use in Patients with Established Cardiovascular Disease: A Retrospective, Cross-Sectional Study from NHANES 2009–2010

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Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

CVD:

Cardiovascular disease

CDC:

Centers for Disease Control and Prevention

CAD:

Coronary artery disease

CHF:

Congestive heart failure

COX:

Cyclo-oxygenase

FDA:

Food and Drug Administration

MI:

Myocardial infarction

NHANES:

National Health and Nutrition Examination Survey

NSAIDs:

Nonsteroidal anti-inflammatory drugs

OTC:

Over-the-counter

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Acknowledgements

The project described was partially supported by the National Institute of General Medical Sciences, U54GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

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Authors and Affiliations

  1. School of Pharmacy, West Virginia University, Morgantown, WV, 26506, USA

    Gregory Castelli

  2. Department of Family Medicine, West Virginia University, Morgantown, WV, 26506, USA

    Gregory Castelli, Ashley Petrone, Jun Xiang, Carl Shrader & Dana King

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  1. Gregory Castelli
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  2. Ashley Petrone
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Corresponding author

Correspondence to Ashley Petrone.

Ethics declarations

This was a retrospective analysis of publicly available de-identified data; therefore, no institutional review board approval was warranted for this study.

Conflict of interest

All authors—Gregory Castelli, Ashley Petrone, Jun Xiang, Carl Shrader, and Dana King—declare that they have no conflict of interest that might be relevant to the contents of this article.

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Castelli, G., Petrone, A., Xiang, J. et al. Rates of Nonsteroidal Anti-Inflammatory Drug Use in Patients with Established Cardiovascular Disease: A Retrospective, Cross-Sectional Study from NHANES 2009–2010. Am J Cardiovasc Drugs 17, 243–249 (2017). https://doi.org/10.1007/s40256-016-0212-1

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