Русский
Patients with cardiovascular diseases and NSAIDs intake: Is there a real problem today?
DOI: https://dx.doi.org/10.18565/therapy.2023.4.14-21
Rebrov A.P., Tyapkina M.A., Ordyakova A.A., Yupatov V.D., Kosheleva N.A., Basov I.V.
1) V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia; 2) Regional Clinical Hospital, Saratov
Material and methods. We examined 190 patients hospitalized in the emergency cardiology department of the Regional clinical hospital of Saratov from March to June 2022. It was the full-design study, questionnaire survey was made for all patients hospitalized during the specified period. The questionnaire contained questions regarding the main and concomitant diseases, NSAIDs intake during the month preceding hospitalization. The study involved 122 male and 68 female patients, and average age of them was 60,75±9,74 years old.
Results. During the month before admission to the emergency department, 52% of patients were using NSAIDs for various reasons. The main reasons for hospitalization in most patients were acute coronary pathology and decompensated heart failure. As the main reasons for NSAIDs intake, patients note musculoskeletal system disorders and headache. The majority of patients (65%) should take NSAIDs more than once a week, 39% of patients – for 3 months. 26% of patients used two or more NSAIDs simultaneously during the last month.
Conclusion. More than half of patients admitted to emergency cardiology departments had taken NSAIDs during the month prior to hospitalization. Most patients were bound to use NSAIDs often, regularly, for a long time. In this regard, active medical tactics is required to identify the fact and clarify the peculiarities of NSAIDs use in this category of patients. The choice of medicines in most patients remains suboptimal, often several of them are combined, and different methods of their administration are taking place. Thus, the situation with NSAIDs use in CVD patients requires additional informing both patients and doctors about the peculiarities of their use in this category of health care consumers.
Literature
1. Schjerning A.M., McGettigan P., Gislason G. Cardiovascular effects and safety of (non-aspirin) NSAIDs. Nat Rev Cardiol. 2020; 17(9): 574–84. https://dx.doi.org/10.1038/s41569-020-0366-z. 2. Wan E.Y.F., Yu Y.E.T., Chan L. et al. Comparative risks of nonsteroidal anti-inflammatory drugs on cardiovascular diseases: A population-based cohort study. J Clin Pharmacol. 2023; 63(1): 126–34. https://dx.doi.org/10.1002/jcph.2142. 3. Martin Arias L.H., Martin Gonzalez A., Sanz Fadrique R., Vazquez ES. Cardiovascular risk of nonsteroidal anti-inflammatory drugs and classical and selective cyclooxygenase-2 inhibitors: A meta-analysis of observational studies. J Clin Pharmacol. 2019; 59(1): 55–73. https://dx.doi.org/10.1002/jcph.1302. 4. Minhas D., Nidhaan A., Husni M.E. Recommendations for the use of nonsteroidal anti-inflammatory drugs and cardiovascular disease risk: Decades later, any new lessons learned? Rheum Dis Clin North Am. 2023; 49(1): 179–91.https://dx.doi.org/10.1016/j.rdc.2022.08.006. 5. Каратеев А.Е., Насонов Е.Л., Ивашкин В.Т. с соавт. Рациональное использование нестероидных противовоспалительных препаратов. Клинические рекомендации. Научно-практическая ревматология. 2018; 56(Прил. 1): 1–29. [Karateev A.E., Nasonov E.L., Ivashkin V.T. et al. Rational use of nonsteroidal anti-inflammatory drugs. Clinical guidelines. Nauchno-Prakticheskaya Revmatologiya = Rheumatology Science and Practice. 2018; 56(Suppl. 1): 1–29 (In Russ.)]. https://dx.doi.org/10.14412/1995-4484-2018-1-29. 6. Ребров А.П., Тяпкина М.А, Кошелева Н.А. Пациенты с сердечно-сосудистыми заболеваниями и прием НПВП: реальная клиническая практика. Архивъ внутренней медицины. 2021; 11(1): 5–10. [Rebrov A.P., Tyapkina M.A., Kosheleva N.A. Patients with cardiovascular diseases and NSAIDs use: real clinical practice. Arkhiv vnutrenney meditsiny = The Russian Archives of Internal Medicine. 2021; 11(1): 5–10 (In Russ.)]. https://dx.doi.org/10.20514/2226-6704-2021-11-1-5-10. 7. Ребров А.П., Григорьева Е.В., Петров Г.С. с соавт. Пациенты, получающие заместительную почечную терапию гемодиализом, и прием НПВС: реальная клиническая практика. Клиническая нефрология. 2021; 4: 43–47. [Rebrov A.P., Grigoryeva E.V., Petrov G.S. et al. Patients receiving renal replacement therapy with hemodialysis and taking NSAIDs: real clinical practice. Klinicheskaya nefrologiya = Clinical Nephrology. 2021; 4: 43–47 (In Russ.)]. https://dx.doi.org/10.18565/nephrology.2021.4.43-47. 8. Sampaio Rocha-Filho P.A. Headache associated with COVID-19: Epidemiology, characteristics, pathophysiology, and management. Headache. 2022; 62(6): 650–56. https://dx.doi.org/10.1111/head.14319. 9. Kushner P., McCarberg B.H., Grange L. et al. The use of non-steroidal anti-inflammatory drugs (NSAIDs) in COVID-19. NPJ Prim Care Respir Med. 2022; 32(1): 35. https://dx.doi.org/10.1038/s41533-022-00300-z. 10. Khoja O., Silva Passadouro B., Mulvey M. et al. Clinical characteristics and mechanisms of musculoskeletal pain in long COVID. J Pain Res. 2022; 15: 1729–48. https://dx.doi.org/10.2147/JPR.S365026. 11. Chung M.K., Zidar D.A., Bristow M.R. et al. COVID-19 and cardiovascular disease: From bench to bedside. Circ Res. 2021 ;128(8): 1214–36. https://dx.doi.org/10.1161/CIRCRESAHA.121.317997. 12. Bakılan F., Gokmen I.G., Ortanca B. et al. Musculoskeletal symptoms and related factors in postacute COVID-19 patients. Int J Clin Pract. 2021; 75(11): e14734. https://dx.doi.org/10.1111/ijcp.14734. 13. Karaarslan F., Demircioglu Guneri F., Kardes S. Postdischarge rheumatic and musculoskeletal symptoms following hospitalization for COVID-19: prospective follow-up by phone interviews. Rheumatol Int. 2021; 41(7): 1263–71.https://dx.doi.org/10.1007/s00296-021-04882-8. 14. Solomon D.H., Husni M.E., Wolski K.E. et al. Differences in safety of nonsteroidal antiinflammatory drugs in patients with osteoarthritis and patients with rheumatoid arthritis: A randomized clinical trial. Arthritis Rheumatol. 2018; 70(4): 537–46.https://dx.doi.org/10.1002/art.40400.
About the Autors
Andrey P. Rebrov, MD, professor, head of the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. E-mail: andreyrebrov@yandex.ru. ORCID: https://orcid.org/0000-0002-3463-7734
Maria A. Tyapkina, PhD in Medical Sciences, associate professor of the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. E-mail: mariya-tyapkina@yandex.ru. ORCID: https://orcid.org/0000-0002-1860-3171
Anna A. Ordyakova, assistant at the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. E-mail: anna-ordyakova@mail.ru. ORCID: https://orcid.org/0000-0002-6088-6259
Vladimir D. Yupatov, assistant at the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia. Address: 410012, Saratov, 112 Bolshaya Kazachya Str. E-mail: bobstersar@gmail.com. ORCID: https://orcid.org/0000-0001-8599-2990
Natalya A. Kosheleva, MD, professor, head of the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia, head of the Department of emergency cardiology No. 2 of Regional Clinical Hospital (Saratov). Address: 410053, Saratov, 1/1 Microraion Smirnovskoe Uschelie Str. E-mail: kosheleva2009@yandex.ru.
ORCID: https://orcid.org/0000-0001-5585-946X
Igor V. Basov, assistant at the Department of hospital therapy of the Faculty of general medicine, V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia, head of the Department of emergency cardiology No. 3 of Regional Clinical Hospital (Saratov). Address: 410053, Saratov, 1/1 Microraion Smirnovskoe Uschelie Str. E-mail: basov7373@mail.ru
Similar Articles
