Non-steroidal anti-inflammatory drug use and functional outcome from ischemic cerebral events among women
Pamela M Rist1, M Maria Glymour2, E John Orav3
1Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States.
Background:
Use of some non-steroidal anti-inflammatory drugs (NSAIDs) has been linked to an increased risk of stroke. However, information on the impact of NSAID use on functional outcomes from stroke is limited.
Methods:
Using women enrolled in the Women's Healthy Study who were free of a history of stroke or TIA at baseline, a prospective cohort study was performed to examine the impact of NSAID use on functional outcomes from stroke. Women were classified as NSAID non-user (<11 days of use in the past month), user (≥ 11 days of use in the past month), and missing (did not answer the question about NSAID use) during each year of the study. Possible functional outcomes were TIA or ischemic stroke with modified Rankin scale (mRS) score of 0 to 1, 2 to 3, or 4 to 6.
Results:
After 15.7 mean years of follow-up, 702 TIAs, 292 ischemic strokes with mRS 0-1, 233 ischemic strokes with mRS 2-3 and 98 ischemic strokes with mRS 4-6 occurred. Compared to women who were NSAID non-users, women who were NSAID users had multivariable-adjusted (95% CI) of 1.00 (0.77, 1.29) for TIA, 1.48 (1.04, 2.10) for mRS 0-1, 0.83 (0.52, 1.33) for mRS 2-3, and 1.33 (0.68, 2.59) for mRS 4-6.
Conclusion:
Results from this large cohort study suggest than NSAID use may be associated with an increased risk of ischemic stroke with mild functional outcome.
