In a study from Copenhagen University Hospital, scientists found short-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a first-time hospitalization for heart failure in patients with type 2 diabetes.
NSAID (celecoxib, diclofenac, ibuprofen, and naproxen) use has been linked to an increased risk of heart failure in the general population but data are lacking in patients with type 2 diabetes.
Given that patients with type 2 diabetes have over twice the likelihood of developing heart failure as those without diabetes, NSAIDs could be even more detrimental in this at-risk group.
In the study, the team examined the association between short-term NSAID use and the risk of heart failure hospitalization in more than 330,000 patients with type 2 diabetes.
They used Danish registers to identify patients diagnosed with type 2 diabetes during 1998 to 2021. The average age of the patients was 62 years and 44% were women.
The team found during the first year after inclusion in the study, 16% of patients claimed at least one NSAID prescription while 3% claimed at least three prescriptions.
Ibuprofen was used by 12.2% of patients, diclofenac by 3.3%, naproxen by 0.9%, and celecoxib by 0.4%. During a follow up of 5.85 years, 23,308 patients were hospitalized with heart failure for the first time.
NSAID use was linked to an elevated risk of first-time heart failure hospitalization.
When individual NSAIDs were analyzed, the risk of heart failure hospitalization was increased following the use of diclofenac or ibuprofen.
Celecoxib and naproxen were not associated with an increased risk, potentially due to the small proportion of claimed prescriptions.
The researchers also analyzed the risk of heart failure with NSAID use in subgroups of patients.
No association was found in patients with normal glycated hemoglobin (HbA1c) levels (below 48 mmol/mol), which indicates well-controlled diabetes.
Strong associations were found in patients above 65 years of age, while no association was found in those below 65 years of age. The strongest association was found in very infrequent or new users of NSAIDs.
The results suggest that a potential increased risk of heart failure should be taken into account when considering the use of these medications.
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The study was conducted by Dr. Anders Holt et al and presented at ESC Congress 2022.
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