The effect of NSAID use on emergency department visits with decompensated heart failure

This study aimed to evaluate the association between recent nonsteroidal anti-inflammatory drug (NSAID) use and clinical presentation and in-hospital outcomes among patients presenting to the emergency department with acute decompensated heart failure.

This prospective, single-center, observational study was conducted between October 20, 2023, and May 21, 2025, in the Emergency Medicine Department of a University Hospital. A total of 400 patients diagnosed with decompensated heart failure were included. For statistical analyses, differences between patients who used NSAIDs and those who did not were compared using Pearson's Chi-Square Test, while Fisher's Exact Test was applied when appropriate.

Among the 400 participants, 54.3% were female, and 54.0% were aged ≥ 80 years. NSAID use within the preceding 10 days was observed in 27.8% of patients. A substantial proportion of patients presented with advanced heart failure, with the majority classified as NYHA Class III or IV, and 44.0% required intensive care unit admission during hospitalization. NSAID use was more frequently observed among older patients and in those presenting with clinical features such as hypertension and tachypnea. However, no consistent or statistically significant associations were identified between recent NSAID exposure and in-hospital mortality or intensive care unit admission. These findings should be interpreted in the context of the study's observational design and the presence of multiple clinical confounders.

Recent NSAID use was common among patients presenting to the emergency department with acute decompensated heart failure. In this cohort, NSAID exposure was not clearly associated with differences in in-hospital outcomes, and further analyses adjusting for clinical confounders are warranted.