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Identifying Risk Factors for Cardiovascular Events Among Active-Duty Service Members and Veterans Prescribed
Whitney L Forbes1, Justin Petway2, Laura E Gressler3
1Enterprise Intelligence and Data Solutions Program Management Office, Program Executive Office, Defense Healthcare Management Systems, Rosslyn, VA, USA.
Journal of Pain Research
|March 20, 2024
Summary
Patient age, initial exposure duration, and existing health conditions are key risk factors for cardiovascular events in nonsteroidal anti-inflammatory drug (NSAID) users. NSAID selectivity and dosage showed less impact on cardiovascular risk.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Epidemiology
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for pain and inflammation.
- NSAID use is linked to cardiovascular events due to cyclooxygenase (COX) enzyme inhibition.
- Factors influencing NSAID-related cardiovascular risk require further investigation.
Purpose of the Study:
- To identify patient and prescription-related risk factors for cardiovascular events in individuals using NSAIDs.
- To characterize the association between NSAID use and adverse cardiovascular outcomes.
Main Methods:
- Retrospective, nested case-control study using the DAVINCI database (FY2015-FY2020).
- Included active-duty service members and veterans aged ≥18 years with NSAID prescriptions.
- Cases: nonfatal myocardial infarction, stroke, or new heart failure; Controls: 10 per case. Logistic regression used for analysis.
Main Results:
- Strongest risk factors for cardiovascular events included age (45-75+ years), early NSAID exposure (first 90 days), cerebrovascular disease, cardiomyopathy, and prior myocardial infarction.
- NSAID cyclooxygenase (COX)-selectivity and dosage were not significantly associated with cardiovascular events.
Conclusions:
- Patient demographics (age) and comorbidities are more significant predictors of cardiovascular events than NSAID-specific factors like COX-selectivity or dose.
- Findings support the development of a predictive risk score for NSAID-associated cardiovascular events.
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