Heart Failure Following Anti-Inflammatory Medications in Patients With Type 2 Diabetes Mellitus
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Heart Failure Following Anti-Inflammatory Medications in Patients With Type 2 Diabetes Mellitus. / Holt, Anders; Strange, Jarl E.; Nouhravesh, Nina; Nielsen, Sebastian Kinnberg; Malik, Mariam Elmegaard; Schjerning, Anne Marie; Køber, Lars; Torp-Pedersen, Christian; Gislason, Gunnar H.; McGettigan, Patricia; Schou, Morten; Lamberts, Morten.
In: Journal of the American College of Cardiology, Vol. 81, No. 15, 2023, p. 1459-1470.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Heart Failure Following Anti-Inflammatory Medications in Patients With Type 2 Diabetes Mellitus
AU - Holt, Anders
AU - Strange, Jarl E.
AU - Nouhravesh, Nina
AU - Nielsen, Sebastian Kinnberg
AU - Malik, Mariam Elmegaard
AU - Schjerning, Anne Marie
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar H.
AU - McGettigan, Patricia
AU - Schou, Morten
AU - Lamberts, Morten
N1 - Publisher Copyright: © 2023 American College of Cardiology Foundation
PY - 2023
Y1 - 2023
N2 - Background: Fluid retention and endothelial dysfunction have been related to use of nonsteroidal anti-inflammatory drugs (NSAIDs), and type 2 diabetes mellitus (T2DM) has been linked to both a decline in kidney function and subclinical cardiomyopathy. Objectives: The authors hypothesized that short-term use of NSAIDs could lead to subsequent development of incident heart failure (HF) in patients with T2DM. Methods: Using nationwide Danish registers, we identified patients diagnosed with T2DM during 1998 to 2021 and included patients without previous HF, rheumatic disease, or use of NSAIDs 120 days before diagnosis. Associations between NSAIDs and first-time HF hospitalization were investigated using a case-crossover design with 28-day exposure windows, and ORs with 95% CIs were reported. Results: Included were 331,189 patients with T2DM: 44.2% female, median age of 62 years (IQR: 52-71 years); 23,308 patients were hospitalized with HF during follow-up, and 16% of patients claimed at least 1 NSAID prescription within 1 year. Short-term use of NSAIDs was associated with increased risk of HF hospitalization (OR: 1.43; 95% CI: 1.27-1.63), most notably in subgroups with age ≥80 years (OR: 1.78; 95% CI: 1.39-2.28), elevated hemoglobin (Hb) A1c levels treated with 0 to 1 antidiabetic drug (OR: 1.68; 95% CI: 1.00-2.88), and without previous use of NSAIDs (OR: 2.71; 95% CI: 1.78-4.23). Conclusions: NSAIDs were widely used and were associated with an increased risk of first-time HF hospitalization in patients with T2DM. Patients with advanced age, elevated HbA1c levels, and new users of NSAID seemed more susceptible. These findings could guide physicians prescribing NSAIDs.
AB - Background: Fluid retention and endothelial dysfunction have been related to use of nonsteroidal anti-inflammatory drugs (NSAIDs), and type 2 diabetes mellitus (T2DM) has been linked to both a decline in kidney function and subclinical cardiomyopathy. Objectives: The authors hypothesized that short-term use of NSAIDs could lead to subsequent development of incident heart failure (HF) in patients with T2DM. Methods: Using nationwide Danish registers, we identified patients diagnosed with T2DM during 1998 to 2021 and included patients without previous HF, rheumatic disease, or use of NSAIDs 120 days before diagnosis. Associations between NSAIDs and first-time HF hospitalization were investigated using a case-crossover design with 28-day exposure windows, and ORs with 95% CIs were reported. Results: Included were 331,189 patients with T2DM: 44.2% female, median age of 62 years (IQR: 52-71 years); 23,308 patients were hospitalized with HF during follow-up, and 16% of patients claimed at least 1 NSAID prescription within 1 year. Short-term use of NSAIDs was associated with increased risk of HF hospitalization (OR: 1.43; 95% CI: 1.27-1.63), most notably in subgroups with age ≥80 years (OR: 1.78; 95% CI: 1.39-2.28), elevated hemoglobin (Hb) A1c levels treated with 0 to 1 antidiabetic drug (OR: 1.68; 95% CI: 1.00-2.88), and without previous use of NSAIDs (OR: 2.71; 95% CI: 1.78-4.23). Conclusions: NSAIDs were widely used and were associated with an increased risk of first-time HF hospitalization in patients with T2DM. Patients with advanced age, elevated HbA1c levels, and new users of NSAID seemed more susceptible. These findings could guide physicians prescribing NSAIDs.
KW - heart failure
KW - nonsteroidal anti-inflammatory drug
KW - pharmacoepidemiology
KW - type 2 diabetes mellitus
U2 - 10.1016/j.jacc.2023.02.027
DO - 10.1016/j.jacc.2023.02.027
M3 - Journal article
C2 - 37045515
AN - SCOPUS:85151400901
VL - 81
SP - 1459
EP - 1470
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 15
ER -
ID: 344448711