Non-steroidal anti-inflammatory drugs and risk of venous thromboembolism: a systematic review and meta-analysis

Patompong Ungprasert; Narat Srivali; Karn Wijarnpreecha; Prangthip Charoenpong; Eric L Knight

doi:10.1093/rheumatology/keu408

Non-steroidal anti-inflammatory drugs and risk of venous thromboembolism: a systematic review and meta-analysis

Rheumatology (Oxford). 2015 Apr;54(4):736-42. doi: 10.1093/rheumatology/keu408. Epub 2014 Sep 24.

Authors

Patompong Ungprasert¹, Narat Srivali², Karn Wijarnpreecha³, Prangthip Charoenpong², Eric L Knight²

Affiliations

¹ Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA, Cardiac Electrophysiology Unit, Department of Physiology, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand and Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA. p.ungprasert@gmail.com.
² Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA, Cardiac Electrophysiology Unit, Department of Physiology, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand and Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.
³ Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA, Cardiac Electrophysiology Unit, Department of Physiology, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand and Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA. Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, NY, USA, Cardiac Electrophysiology Unit, Department of Physiology, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand and Department of Internal Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, USA.

PMID: 25252703
DOI: 10.1093/rheumatology/keu408

Abstract

Objective: The aim of this study was to integrate and examine the association between NSAID use and venous thromboembolism (VTE).

Methods: We conducted a systematic review and meta-analysis of studies that reported odds ratios, relative risks, hazard ratios or standardized incidence ratios for VTE among NSAID users compared with non-users. Pooled risk ratios and 95% CIs were calculated using a random effects generic inverse variance model.

Results: Six studies with 21 401 VTE events were identified and included in the data analysis. The pooled risk ratio of VTE in NSAID users was 1.80 (95% CI 1.28, 2.52).

Conclusion: Our study demonstrated a statistically significant increased risk of VTE among NSAID users. This finding has important public health implications given the prevalence of NSAID use in the general population.

Keywords: NSAIDs; epidemiology; meta-analysis; respiratory; systematic review.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
Humans
Incidence
Odds Ratio
Proportional Hazards Models
Pulmonary Embolism / chemically induced
Pulmonary Embolism / epidemiology*
Venous Thromboembolism / chemically induced
Venous Thromboembolism / epidemiology*
Venous Thrombosis / chemically induced
Venous Thrombosis / epidemiology*

Substances

Anti-Inflammatory Agents, Non-Steroidal