Association between nonsteroidal anti-inflammatory drugs and atrial fibrillation among a middle-aged population

A nationwide population-based cohort

Shao Yuan Chuang, Pai Feng Hsu, Fang Ju Lin, Ya Wen Huang, Gou Zhau Wang, Wei Chiao Chang, Hui Ju Tsai

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aims: It remains inconclusive whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of atrial fibrillation (AF), especially in middle-aged Asian populations. In this study, we evaluated the association between NSAID use and the risk of AF in a nationwide population-based study of middle-aged individuals in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified the cases with a diagnosis of AF (ICD-9-CM codes: 427.31) and the matched controls from three independent Longitudinal Health Insurance Databases (LHIDs) derived from the NHIRD from data collected from 2001 to 2013. Conditional logistic regression models with covariate adjustment were performed to evaluate the association between NSAID use and the risk of AF. Results: A total of 57058 participants (28529 AF cases and 28529 matched controls) were included. Participants with NSAID use had an elevated risk of AF compared to non-users [adjusted odds ratio (AOR) = 1.18, 95% confidence interval (CI): 1.14-1.23]. When further assessing the effects of different classes of NSAIDs on the risk of AF, the results showed that participants who used non-selective NSAIDs had a significantly elevated risk of AF (AOR = 1.18, 95% CI: 1.13-1.23), as did participants with a combined use of selective and non-selective NSAIDs (AOR = 1.30, 95% CI: 1.21-1.39). Conclusions: NSAID use was associated with an increased risk of AF occurrence among the participants included in our study cohort. Closely monitoring the adverse effects of NSAID treatment on the risk of AF will be important, particularly among individuals at high risk.

Original languageEnglish
JournalBritish Journal of Clinical Pharmacology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Atrial Fibrillation
Anti-Inflammatory Agents
Pharmaceutical Preparations
Population
Odds Ratio
National Health Programs
Databases
Confidence Intervals
Taiwan
Logistic Models
International Classification of Diseases
Health Insurance
Research
Case-Control Studies
Cohort Studies

Keywords

  • Atrial fibrillation
  • Middle-aged population
  • Nationwide population-based study
  • Nonsteroidal anti-inflammatory drugs

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Association between nonsteroidal anti-inflammatory drugs and atrial fibrillation among a middle-aged population : A nationwide population-based cohort. / Chuang, Shao Yuan; Hsu, Pai Feng; Lin, Fang Ju; Huang, Ya Wen; Wang, Gou Zhau; Chang, Wei Chiao; Tsai, Hui Ju.

In: British Journal of Clinical Pharmacology, 01.01.2018.

Research output: Contribution to journalArticle

@article{e08bd80db6334214bd33c8ef21681069,
title = "Association between nonsteroidal anti-inflammatory drugs and atrial fibrillation among a middle-aged population: A nationwide population-based cohort",
abstract = "Aims: It remains inconclusive whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of atrial fibrillation (AF), especially in middle-aged Asian populations. In this study, we evaluated the association between NSAID use and the risk of AF in a nationwide population-based study of middle-aged individuals in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified the cases with a diagnosis of AF (ICD-9-CM codes: 427.31) and the matched controls from three independent Longitudinal Health Insurance Databases (LHIDs) derived from the NHIRD from data collected from 2001 to 2013. Conditional logistic regression models with covariate adjustment were performed to evaluate the association between NSAID use and the risk of AF. Results: A total of 57058 participants (28529 AF cases and 28529 matched controls) were included. Participants with NSAID use had an elevated risk of AF compared to non-users [adjusted odds ratio (AOR) = 1.18, 95{\%} confidence interval (CI): 1.14-1.23]. When further assessing the effects of different classes of NSAIDs on the risk of AF, the results showed that participants who used non-selective NSAIDs had a significantly elevated risk of AF (AOR = 1.18, 95{\%} CI: 1.13-1.23), as did participants with a combined use of selective and non-selective NSAIDs (AOR = 1.30, 95{\%} CI: 1.21-1.39). Conclusions: NSAID use was associated with an increased risk of AF occurrence among the participants included in our study cohort. Closely monitoring the adverse effects of NSAID treatment on the risk of AF will be important, particularly among individuals at high risk.",
keywords = "Atrial fibrillation, Middle-aged population, Nationwide population-based study, Nonsteroidal anti-inflammatory drugs",
author = "Chuang, {Shao Yuan} and Hsu, {Pai Feng} and Lin, {Fang Ju} and Huang, {Ya Wen} and Wang, {Gou Zhau} and Chang, {Wei Chiao} and Tsai, {Hui Ju}",
year = "2018",
month = "1",
day = "1",
doi = "10.1111/bcp.13558",
language = "English",
journal = "British Journal of Clinical Pharmacology",
issn = "0306-5251",
publisher = "Wiley-Blackwell",

}

TY - JOUR

T1 - Association between nonsteroidal anti-inflammatory drugs and atrial fibrillation among a middle-aged population

T2 - A nationwide population-based cohort

AU - Chuang, Shao Yuan

AU - Hsu, Pai Feng

AU - Lin, Fang Ju

AU - Huang, Ya Wen

AU - Wang, Gou Zhau

AU - Chang, Wei Chiao

AU - Tsai, Hui Ju

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aims: It remains inconclusive whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of atrial fibrillation (AF), especially in middle-aged Asian populations. In this study, we evaluated the association between NSAID use and the risk of AF in a nationwide population-based study of middle-aged individuals in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified the cases with a diagnosis of AF (ICD-9-CM codes: 427.31) and the matched controls from three independent Longitudinal Health Insurance Databases (LHIDs) derived from the NHIRD from data collected from 2001 to 2013. Conditional logistic regression models with covariate adjustment were performed to evaluate the association between NSAID use and the risk of AF. Results: A total of 57058 participants (28529 AF cases and 28529 matched controls) were included. Participants with NSAID use had an elevated risk of AF compared to non-users [adjusted odds ratio (AOR) = 1.18, 95% confidence interval (CI): 1.14-1.23]. When further assessing the effects of different classes of NSAIDs on the risk of AF, the results showed that participants who used non-selective NSAIDs had a significantly elevated risk of AF (AOR = 1.18, 95% CI: 1.13-1.23), as did participants with a combined use of selective and non-selective NSAIDs (AOR = 1.30, 95% CI: 1.21-1.39). Conclusions: NSAID use was associated with an increased risk of AF occurrence among the participants included in our study cohort. Closely monitoring the adverse effects of NSAID treatment on the risk of AF will be important, particularly among individuals at high risk.

AB - Aims: It remains inconclusive whether the use of nonsteroidal anti-inflammatory drugs (NSAIDs) increases the risk of atrial fibrillation (AF), especially in middle-aged Asian populations. In this study, we evaluated the association between NSAID use and the risk of AF in a nationwide population-based study of middle-aged individuals in Taiwan. Methods: A nested case-control study was conducted using the National Health Insurance Research Database (NHIRD) in Taiwan. We identified the cases with a diagnosis of AF (ICD-9-CM codes: 427.31) and the matched controls from three independent Longitudinal Health Insurance Databases (LHIDs) derived from the NHIRD from data collected from 2001 to 2013. Conditional logistic regression models with covariate adjustment were performed to evaluate the association between NSAID use and the risk of AF. Results: A total of 57058 participants (28529 AF cases and 28529 matched controls) were included. Participants with NSAID use had an elevated risk of AF compared to non-users [adjusted odds ratio (AOR) = 1.18, 95% confidence interval (CI): 1.14-1.23]. When further assessing the effects of different classes of NSAIDs on the risk of AF, the results showed that participants who used non-selective NSAIDs had a significantly elevated risk of AF (AOR = 1.18, 95% CI: 1.13-1.23), as did participants with a combined use of selective and non-selective NSAIDs (AOR = 1.30, 95% CI: 1.21-1.39). Conclusions: NSAID use was associated with an increased risk of AF occurrence among the participants included in our study cohort. Closely monitoring the adverse effects of NSAID treatment on the risk of AF will be important, particularly among individuals at high risk.

KW - Atrial fibrillation

KW - Middle-aged population

KW - Nationwide population-based study

KW - Nonsteroidal anti-inflammatory drugs

UR - http://www.scopus.com/inward/record.url?scp=85044724423&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044724423&partnerID=8YFLogxK

U2 - 10.1111/bcp.13558

DO - 10.1111/bcp.13558

M3 - Article

JO - British Journal of Clinical Pharmacology

JF - British Journal of Clinical Pharmacology

SN - 0306-5251

ER -