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Study links use of NSAIDs to atrial fibrillation risk

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The current and recent use of non-steroidal anti-inflammatory drugs may be linked to a heightened risk of an irregular heartbeat among older adults, a study has found.

Dutch researchers regularly monitored 8,423 people with an average age of 68.5 for around 13 years. Overall, 857 developed atrial fibrillation.

During the average monitoring period, 857 of the participants developed atrial fibrillation, 261 of whom had never used NSAIDs when they were diagnosed, while 554 had used NSAIDs in the past, and 42 were currently taking these drugs.

Current use was associated with a 76% greater risk of atrial fibrillation than never use, after taking account of other risk factors such as age, sex, and underlying cardiovascular problems.

Similarly, recent use (with the preceding 30 days) of these drugs was linked to an 84% greater risk of atrial fibrillation. While there was a trend for higher doses to be linked to a correspondingly higher risk, this trend was not statistically significant.

NSAIDs may contribute to atrial fibrillation because they inhibit the production of the enzyme cyclo-oxygenase, which may increase blood pressure as a result of fluid retention, suggest the study authors, from the Erasmus Medical Center in Rotterdam.

Alternatively, use of NSAIDs may indicate underlying inflammation, which may increase the risk of atrial fibrillation, the researchers say in the study published in the online journal BMJ Open.

But whatever the explanation, “the underlying mechanism behind this association [between NSAIDs and atrial fibrillation] deserves further attention,” they conclude.


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