Effect of short-term NSAID use on echocardiographic parameters in elderly people: a population-based cohort study

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 longterm 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. Conclusion 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.