title: Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case-time-control study.
abstract: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have been associated with increased cardiovascular risk. Nonetheless, it remains unknown whether use of NSAIDs is associated with out-of-hospital cardiac arrest (OHCA).
  
  
  
  From the nationwide Danish Cardiac Arrest Registry, all persons with OHCA during 2001-10 were identified. NSAID use 30 days before OHCA was categorized as follows: diclofenac, naproxen, ibuprofen, rofecoxib, celecoxib, and other. Risk of OHCA associated with use of NSAIDs was analysed by conditional logistic regression in case-time-control models matching four controls on sex and age per case to account for variation in drug utilization over time. We identified 28 947 persons with OHCA of whom 3376 were treated with an NSAID up to 30 days before OHCA. Ibuprofen and diclofenac were the most commonly used NSAIDs and represented 51.0% and 21.8% of total NSAID use, respectively. Use of diclofenac (odds ratio [OR], 1.50 [95% confidence interval (CI) 1.23-1.82]) and ibuprofen [OR, 1.31 (95% CI 1.14-1.51)] was associated with a significantly increased risk of OHCA. Use of naproxen [OR, 1.29 (95% CI 0.77-2.16)], celecoxib [OR, 1.13 (95% CI 0.74-1.70)], and rofecoxib (OR, 1.28 [95% CI 0.74-1.70)] was not significantly associated with increased risk of OHCA; however, these groups were characterized by few events.
  
  
  
  Use of non-selective NSAIDs was associated with an increased early risk of OHCA. The result was driven by an increased risk of OHCA in ibuprofen and diclofenac users.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.
authors.forename: Kathrine B
authors.initials: KB
authors.lastname: Sondergaard
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Weeke
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.|Emergency Medical Services, Copenhagen, the Capital Region of Denmark, Telegrafvej 5, 2750 Ballerup.
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Schjerning Olsen
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
authors.forename: Emil L
authors.initials: EL
authors.lastname: Fosbol
authors.affiliation: Emergency Medical Services, Copenhagen, the Capital Region of Denmark, Telegrafvej 5, 2750 Ballerup.
authors.forename: Freddy K
authors.initials: FK
authors.lastname: Lippert
authors.affiliation: Institute of Health, Science and Technology, Aalborg University, Fredrik Bajers Vej 7D, 9220 Aalborg Ø , Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.|National Institute of Public Health, University of Southern Denmark, Øster Farimagsgade 5A, 2, 1353 Copenhagen K, Denmark.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28, 2900 Hellerup, Denmark.|Emergency Medical Services, Copenhagen, the Capital Region of Denmark, Telegrafvej 5, 2750 Ballerup.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Folke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D004008:Diclofenac / Q000009:adverse effects*; D004363:Drug Utilization; D006801:Humans; D007052:Ibuprofen / Q000009:adverse effects*; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000453:epidemiology*; D012042:Registries; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D007052:Ibuprofen
keywords: Diclofenac; Ibuprofen; NSAID; OHCA; Pharmacoepidemiology