Table 4

Risk of ischaemic heart disease stratified by NSAID exposure in patients with AS compared with controls

Exposure to NSAIDsTotalMenFemale
Number of subjectsNumber of IHD eventsFully adj HR95% CINumber of subjectsNumber of IHD eventsFully adj HR95% CINumber of subjectsNumber of IHD eventsFully adj HR95% CI
Controls (n=25 299)ReferenceReferenceReference
 No NSAIDs902541856455704686
 Any NSAID1391599234247417
 Naproxen438929471442
 COX-2 inhibitors898484414
 Other NSAIDs 899425993130011
AS (n=3640)
 Any NSAID*
  No2407591.01(0.77 to 1.32)1660420.85(0.62 to 1.16)747171.50(0.89 to 2.53)
  Yes1233431.36(1.00 to 1.85)893341.35(0.95 to 1.92)34091.68(0.84 to 0.334)
 Naproxen†
  No33491011.10(0.88 to 1.37)2347751.02(0.79 to 1.31)1002261.47(0.94 to 2.32)
  Yes29110.26(0.04 to 1.84)20610.29(0.04 to 2.05)850
 COX-2 inhibitors‡
  No3353921.10(0.82 to 1.29)2351680.94(0.72 to 1.22)1002241.45(0.91 to 2.30)
  Yes287103.03(1.61 to 5.69)20283.11(1.54 to 6.29)8521.98(1.34 to 2.92)
 Other NSAIDs§
  No2948700.98(0.77 to 1.27)2039510.89(0.66 to 1.19)909191.46(0.88 to 2.41)
  Yes692321.32(0.93 to 1.89)514251.27(0.85 to 1.90)17871.55(0.71 to 3.37)
  • Bold typeface indicates statistical significance (p<0.05). Patients with AS with or without recent NSAID use were compared with all controls, irrespective of the use of NSAIDs in the control group. The controls are the reference group with an HR of 1.0.

  • *HR adjusted for: age, gender, as well as smoking status, BMI and use of antihypertensives, antiplatelets, antidiabetics, statins in the past 6 months.

  • †HR adjusted for: age, gender, use of COX-II inhibitors and other traditional NSAIDs other than naproxen in the previous 3 months, as well as smoking status, BMI and use of antihypertensives, antiplatelets, antidiabetics, statins in the past 6 months.

  • ‡HR adjusted for: age, gender, use naproxen and other traditional NSAIDs in the previous 3 months, as well as smoking status, BMI and use of antihypertensives, antiplatelets, antidiabetics, statins in the past 6 months.

  • §HR adjusted for: age, gender, use of naproxen and COX-II inhibitors in the previous 3 months, as well as smoking status, BMI and use of antihypertensives, antiplatelets, antidiabetics, statins in the past 6 months.

  • AS, ankylosing spondylitis; adj, adjusted; BMI, body mass index; COX-2 inhibitors, cyclo-oxygenase-2 inhibitor; IHD, ischaemic heart disease; NSAID, non-steroidal anti-inflammatory drugs.