痛风发作可用降尿酸和抗炎药治疗。痛风患者,非甾体抗炎药(NSAIDs)可能对心血管有益,由于它们的抗炎作用,和心血管危险,由于它们的血栓形成,高血压,和致心律失常的副作用。我们,因此,研究痛风患者与使用NSAID相关的心血管事件风险.我们在全国范围内进行了一次,在1997-2020年期间,所有年龄≥18岁的丹麦人首次痛风,经历过心血管事件的基于人群的病例交叉研究(心肌梗塞,缺血性卒中,充血性心力衰竭,心房颤动/扑动,或心血管死亡)(n=59,150)。暴露是使用非甾体抗炎药,总体上和根据类型(布洛芬,萘普生,或双氯芬酸)。我们使用结果日期之前的日期300、240、180和120作为参考日期。我们使用Mantel-Haenszel方法计算NSAID使用与心血管事件之间关联的95%置信区间(CI)的比值比(OR)。使用NSAID总体上与心血管事件几率降低12%相关(OR=0.88,95%CI:0.85-0.91)。使用布洛芬(OR=0.92,95%CI:0.88-0.97)和萘普生(OR=0.85,95%CI:0.74-0.97)观察到比值比降低,但不适用于双氯芬酸(OR=0.97,95%CI:0.90-1.05)。总的来说,非甾体抗炎药的使用与复合结局的所有单个组分的几率降低相关.当用于痛风患者时,NSAIDs与心血管事件发生率增加无关。布洛芬和萘普生似乎比双氯芬酸具有更好的心血管风险特征。
Gout attacks are treated with uric-lowering and anti-inflammatory drugs. In patients with
gout, non-steroidal anti-inflammatory drugs (NSAIDs) could be both cardiovascular beneficial, due to their anti-inflammatory actions, and cardiovascular hazardous, due to their prothrombotic, hypertensive, and proarrhythmic side effects. We, therefore, examined the risk of cardiovascular events associated with NSAID use in patients with
gout. We conducted a nationwide, population-based
case-crossover study of all Danes ≥ 18 years of age with first-time gout during 1997-2020, who experienced a cardiovascular event (myocardial infarction, ischemic stroke, congestive heart failure, atrial fibrillation/flutter, or cardiovascular death) (n = 59,150). The exposure was use of NSAIDs, overall and according to type (ibuprofen, naproxen, or diclofenac). We used the dates 300, 240, 180, and 120 before the outcome date as reference dates. We used the Mantel-Haenszel method to calculate odds ratios (ORs) with 95% confidence intervals (CIs) of the association between NSAID use and cardiovascular events. NSAID use was overall associated with 12% decreased odds of a cardiovascular event (OR = 0.88, 95% CI: 0.85-0.91). This decreased odds ratio was observed for the use of ibuprofen (OR = 0.92, 95% CI: 0.88-0.97) and naproxen (OR = 0.85, 95% CI: 0.74-0.97), but not for the use of diclofenac (OR = 0.97, 95% CI: 0.90-1.05). Overall, use of NSAIDs was associated with decreased odds of all the individual components of the composite outcome. NSAIDs were not associated with an increased cardiovascular event rate when used in
gout patients. Ibuprofen and naproxen appeared to have better cardiovascular risk profiles than diclofenac.