Harmful effects of NSAIDs among patients with hypertension and coronary artery disease

Bavry A A, Khaliq A, Gong Y, Handberg E M, Cooper-Dehoff R M, Pepine C J

This was a post-hoc analysis from the INternational VErapamil Trandolapril STudy (INVEST), in patients with hypertension and coronary artery disease. At each visit, patients were asked by the local site investigator whether they were currently taking non-steroidal anti-inflammatory drugs (NSAIDs). Patients who reported NSAID use at every visit were defined as chronic NSAID users, while all others (occasional or never users) were defined as non-chronic NSAID users. The primary composite outcome was all-cause death, non-fatal myocardial infarction or non-fatal stroke. Cox regression was used to construct a multivariate analysis for the primary outcome. There were 882 chronic NSAID users and 21 694 non-chronic NSAID users (14 408 never users and 7286 intermittent users). At a mean follow-up of 2.7 years, all-cause mortality occurred at a rate of 4.4 events per 100 patient-years in the chronic NSAID group versus 3.7 events per 100 patient-years in the non-chronic NSAID group. This was due to an increase in cardiovascular mortality. …