title: Meta-analysis of nonsteroidal anti-inflammatory drug use and risk of atrial fibrillation.
abstract: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The goal of the present study was to quantify the association between use of nonsteroidal anti-inflammatory drugs (NSAIDs) and risk of AF incidence. MEDLINE and EMBASE were searched for studies that reported risk of AF associated with nonaspirin NSAID use. Combined relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using the random-effects model. Stratified meta-analyses were used to discern which patients were at the highest risk of AF due to NSAID use. Five studies were identified that met the inclusion criteria, 3 of which additionally reported specifically on the association between selective NSAIDs and risk of AF. Overall, NSAID use was associated with a 12% increased risk for AF incidence (RR 1.12, 95% CI 1.06 to 1.18). The association was found to be apparent among new users (RR 1.53, 95% CI 1.37 to 1.70). The increased risk of AF might be explained by the occurrence of chronic heart failure and kidney disease. In addition, use of selective NSAIDs was still related to an increased risk of AF (RR 1.24, 95% CI 1.18 to 1.30). Sensitivity analyses found results to be robust. In conclusion, use of nonaspirin NSAIDs was associated with an increased risk of incident AF. The association was found to be apparent for new users, with a 53% increase in risk. These findings suggest that AF needs to be added to the cardiovascular risks to be considered when prescribing NSAIDs.
authors.affiliation: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Gang
authors.initials: G
authors.lastname: Liu
authors.affiliation: Key Laboratory for Clinical Cardiovascular Genetics and Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Yu-Peng
authors.initials: YP
authors.lastname: Yan
authors.affiliation: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Xin-Xin
authors.initials: XX
authors.lastname: Zheng
authors.affiliation: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Yan-Lu
authors.initials: YL
authors.lastname: Xu
authors.affiliation: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Lu
authors.affiliation: Key Laboratory for Clinical Cardiovascular Genetics and Sino-German Laboratory for Molecular Medicine, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Ru-Tai
authors.initials: RT
authors.lastname: Hui
authors.affiliation: Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China. Electronic address: huangxhong12@gmail.com.
authors.forename: Xiao-Hong
authors.initials: XH
authors.lastname: Huang
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal