Pulmonology Xagena

Acute respiratory infection and use of nonsteroidal anti-inflammatory drugs on risk of acute myocardial infarction

Previous studies have suggested that acute respiratory infection ( ARI ) and nonsteroidal anti-inflammatory drugs ( NSAIDs ) use could trigger acute myocardial infarction ( AMI ).
In some countries, physicians prescribe NSAIDs for patients with acute respiratory infection for symptom relief.
However, there is no research evaluating whether NSAIDs use during ARI episodes may increase the risk of acute myocardial infarction.

Researchers identified 9793 patients with an incident hospitalization of acute myocardial infarction ( index date ) between 2007 and 2011.

Using case-crossover design, researchers have compared the following exposure status between the case ( 1–7-day before index date ) and matched control period ( 366–372-day before index date ): NSAIDs use during ARI episodes, ARI episodes without NSAIDs use, NSAIDs use only, or no exposure.

Nonsteroidal anti-inflammatory drugs use during ARI was associated with a 3.4-fold increased risk of acute myocardial infarction ( adjusted odds ratio [ aOR ] = 3.41; 95% confidence interval [ CI ] = 2.80–4.16 ), ARI without NSAIDs use was associated with a 2.7-fold increased risk ( aOR = 2.65; 95% CI = 2.29–3.06 ), and NSAIDs use only was associated with a 1.5-fold increased risk ( aOR = 1.47; 95% CI = 1.33–1.62 ). Moreover, parenteral NSAIDs were associated with much higher risk in ARI patients ( aOR = 7.22; 95% CI = 4.07–12.81 ).

In conclusions, nonsteroidal anti-inflammatory drugs use during ARI episodes, especially parenteral NSAIDs, was associated with a further increased risk of acute myocardial infarction. ( Xagena )

Wen YC et al, J Infect Dis 2017; 215: 503-509