title: Associations between aspirin and other non-steroidal anti-inflammatory drugs and aortic valve or coronary artery calcification: the Multi-Ethnic Study of Atherosclerosis and the Heinz Nixdorf Recall Study.
abstract: BACKGROUND
  The association between non-steroidal anti-inflammatory drugs (NSAIDs) and the incidence of valvular and arterial calcification is not well established despite known associations between these drugs and cardiovascular events.
  
  
  OBJECTIVE
  To compare the association between the baseline use of aspirin with other NSAID class medications with the incidence and prevalence of aortic valve calcification (AVC) and coronary artery calcification (CAC).
  
  
  METHODS
  The relationship of NSAID use to AVC and CAC detected by computed tomography was assessed in 6814 participants within the Multi-Ethnic Study of Atherosclerosis (MESA) using regression modeling. Results were adjusted for age, sex, ethnicity, study site, anti-hypertensive medication use, education, income, health insurance status, diabetes, smoking, exercise, body mass index, blood pressure, serum lipids, inflammatory markers, fasting glucose, statin medication use, and a simple diet score. Medication use was assessed by medication inventory at baseline which includes the use of non-prescription NSAIDs. MESA collects information on both incident and prevalent calcification. The 4814 participants of the Heinz Nixdorf Recall (HNR) Study, a German prospective cohort study with similar measures of calcification, were included in this analysis to enable replication.
  
  
  RESULTS
  Mean age of the MESA participants was 62 years (51% female). After adjustment for possible confounding factors, a possible association between aspirin use and incident AVC (Relative Risk(RR): 1.60; 95%Confidence Interval (CI): 1.19-2.15) did not replicate in the HNR cohort (RR: 1.06; 95%CI: 0.87-1.28). There was no significant association between aspirin use and incident CAC in the MESA cohort (RR 1.08; 95%CI: 0.91-1.29) or in the HNR cohort (RR 1.24; 95%CI: 0.87-1.77). Non-aspirin NSAID use was not associated with either AVC or CAC in either cohort. There were no associations between regular cardiac dose aspirin and incident calcification in either cohort.
  
  
  CONCLUSIONS
  Baseline NSAID use, as assessed by medication inventory, appears to have no protective effect regarding the onset of calcification in either coronary arteries or aortic valves.
authors.affiliation: College of Pharmacy, University of Florida, USA. jacd@uw.edu
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Delaney
authors.forename: Nils
authors.initials: N
authors.lastname: Lehmann
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Jöckel
authors.forename: Sammy
authors.initials: S
authors.lastname: Elmariah
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.forename: Amir A
authors.initials: AA
authors.lastname: Mahabadi
authors.forename: Matt
authors.initials: M
authors.lastname: Budoff
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.forename: Khurram
authors.initials: K
authors.lastname: Nasir
authors.forename: Kevin D
authors.initials: KD
authors.lastname: O'Brien
authors.forename: Stefan
authors.initials: S
authors.lastname: Möhlenkamp
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.forename: Nico
authors.initials: N
authors.lastname: Dragano
authors.forename: Almut G
authors.initials: AG
authors.lastname: Winterstein
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Hagen
authors.initials: H
authors.lastname: Kälsch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001024:Aortic Valve Stenosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000208:ethnology; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D002114:Calcinosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000208:ethnology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000208:ethnology; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D001241:Aspirin
keywords: Aortic valve calcification; Aspirin; Coronary artery calcification; Heinz Nixdorf Recall Study; Multi-Ethnic Study of Atherosclerosis; Non-steroidal anti-inflammatory drugs