title: Effect of short-term NSAID use on echocardiographic parameters in elderly people: a population-based cohort study.
abstract: BACKGROUND
  Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with an increased risk of heart failure. NSAIDs inhibit the synthesis of renal prostaglandin, which results in a higher total blood volume, cardiac output and preload. The association between recent start of NSAIDs in elderly people and echocardiographic parameters was investigated.
  
  
  METHODS
  In the Rotterdam Study, a population-based cohort study, the effect of NSAIDs on left ventricular end-systolic dimension, left ventricular end-diastolic dimension, fractional shortening and left ventricular systolic function was studied in all participants for whom an echocardiogram was available (n=5307). NSAID use was categorised as current NSAID use on the date of echocardiography, past use and never used before echocardiography during the study period. Current use was divided into short-term NSAID use (≤ 14 days) and long-term NSAID use (> 14 days). Associations between drug exposure and echocardiographic measurements were assessed using linear and logistic regression analyses.
  
  
  RESULTS
  Current NSAID use for < 14 days was associated with a significantly higher left ventricular end-systolic dimension (+1.74 mm, 95% CI 0.20 to 3.28), left ventricular end-diastolic dimension (+3.69 mm, 95% CI 1.08 to 6.31) and significantly lower fractional shortening (-6.03%, 95% CI -9.81% to -2.26%) compared with non-users. Current NSAID use for > 14 days was associated with a higher left end-diastolic dimension (+1.96 mm, 95% CI 0.82 to 3.11) but there was no change in the other echocardiographic parameters.
  
  
  CONCLUSIONS
  This study is the first to investigate the association between NSAIDs and echocardiographic parameters and suggests that there is a transient effect of short-term use of NSAIDs on the left ventricular dimension and function of the heart.
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Karen Eline
authors.initials: KE
authors.lastname: van den Hondel
authors.forename: Mark
authors.initials: M
authors.lastname: Eijgelsheim
authors.forename: Rikje
authors.initials: R
authors.lastname: Ruiter
authors.forename: Jaqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced* / Q000000981:diagnostic imaging
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal