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  • Lash, Timothy L.  (2)
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  • 1
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 32, No. 11 ( 2023-11), p. 1233-1243
    Abstract: Non‐steroidal anti‐inflammatory drugs (NSAIDs) should be used cautiously in patients with type 2 diabetes. We examined whether the cardiovascular risks associated with NSAID use depended on HbA1c level in patients with type 2 diabetes. Methods We conducted a population‐based cohort study of all adult Danes with a first‐time HbA1c measurement ≥48 mmol/mol during 2012–2020 (n = 103 308). We used information on sex, age, comorbidity burden, and drug use to calculate time‐varying inverse probability of treatment weights. After applying these weights in a pooled logistic regression, we estimated hazard ratios (HRs) of the association between use of NSAIDs (ibuprofen, naproxen, or diclofenac) and cardiovascular events (a composite of myocardial infarction, ischemic stroke, congestive heart failure, atrial fibrillation or flutter, and all‐cause death). We stratified all analyses by HbA1c level ( 〈 53 or ≥53 mmol/mol). Results For ibuprofen use, the HR of a cardiovascular event was 1.53 (95% confidence interval [CI]: 1.34–1.75) in patients with HbA1c 〈 53 and 1.24 (95% CI: 1.00–1.53) in patients with HbA1c ≥53 mmol/mol. For naproxen use, the HR was 1.14 (95% CI: 0.59–2.21) in patients with HbA1c 〈 53 and 1.30 (95% CI: 0.49–3.49) in patients with HbA1c ≥53 mmol/mol. For diclofenac use, the HR was 2.40 (95% CI: 1.62–3.56) in patients with HbA1c 〈 53 and 2.89 (95% CI: 1.65–5.04) in patients with HbA1c ≥53 mmol/mol. Conclusions In patients with type 2 diabetes, glycemic dysregulation did not affect the cardiovascular risk associated with NSAID use.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1491218-1
    SSG: 15,3
    Location Call Number Limitation Availability
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  • 2
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 32, No. 4 ( 2023-04), p. 455-467
    Abstract: Lifestyle and socioeconomic position may confound the link between non‐steroidal anti‐inflammatory drugs (NSAIDs) and cardiovascular events, if associated with NSAID use. We examined this association. Methods We conducted a cohort study of all adult first‐time responders to the Danish National Health Surveys of 2010, 2013, or 2017 without an NSAID prescription within 3 months before survey completion ( n  = 407 395). Study exposures were weight, smoking status, alcohol consumption, binge drinking frequency, physical activity level, marital status, highest achieved level of education, income, and employment status. We used a Cox model to compute hazard ratios of time to first redemption of an NSAID prescription and a cumulative odds model to compute odds ratios (ORs) of redeeming one additional NSAID prescription in the year after survey completion. Results Total follow‐up time was 1 931 902 years. The odds of redeeming one additional NSAID prescription in the year after survey completion varied within all categories of lifestyle and socioeconomic position. The largest ORs were observed within categories of weight (1.70, 95% CI: 1.65–1.74 for obesity vs. normal weight), smoking status (1.24, 95% CI: 1.21–1.27 for current vs. never use), and education (1.44, 95% CI: 1.39–1.49 for primary or other vs. university or higher education). The Cox model showed consistent results. Conclusions Markers of unhealthy lifestyle and low socioeconomic position were associated with initiation and prolonged NSAID use. Consideration of lifestyle and socioeconomic markers as potential confounders in NSAID studies is therefore recommended.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1491218-1
    SSG: 15,3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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