Key result
NSAIDs appear in ~71% of musculoskeletal prescriptions among ambulatory post-MI patients.
Why the study?
Guidelines recommend caution regarding NSAID use after MI, but real-world studies in ambulatory settings are rare.
Cross-Sectional (n=75,131)
Absolute Event Rate: 70.7% vs 43.5%
p-value: p=<0.001
Despite guideline recommendations to use caution with NSAIDs after myocardial infarction, they remain highly prescribed in ambulatory settings, particularly for musculoskeletal diseases.
Frequent post-MI NSAID prescriptions signal ambulatory guideline gaps; leaves open whether targeted interventions improve safety.
Although current guidelines for myocardial infarction (MI) recommend caution in using non-steroidal anti-inflammatory drugs (NSAIDs), real-world studies of ambulatory settings are rare. This study aimed to explore the patterns and trends of analgesic prescriptions (especially NSAIDs) among patients with a history of MI in ambulatory care settings in Korea. We analyzed real-world data from the Korea National Health Insurance Service database. Patients aged 20 years or older hospitalized with incident MI were identified between January 2007 and December 2015. Ambulatory analgesics were administered after discharge from incident hospitalization for MI, and annual trends in the prescriptions of individual analgesics were evaluated. Among the 93,597 patients with incident MI, 75,131 (80.3%) received a total of 2,081,705 ambulatory analgesic prescriptions. Prescriptions were mainly issued at primary care clinics (80.3%). Analgesics were most frequently prescribed for musculoskeletal diseases (often NSAIDs, 70.7%); aceclofenac (13.7%) and diclofenac injection (9.4%) were the frequently used NSAIDs. Additionally, significant changes were observed in the trends for some analgesics, such as loxoprofen. This study suggested that NSAIDs are commonly prescribed to patients with a history of MI. Future real-world studies are needed to elucidate the drug-disease interactions of NSAIDs prescribed after MI, especially for patients with musculoskeletal diseases.
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Jung et al. (2022) conducted a cross-sectional in Myocardial infarction (n=75,131). Ambulatory analgesic prescriptions (NSAIDs) was evaluated on Proportion of prescriptions including NSAIDs for musculoskeletal diseases versus respiratory diseases (p=<0.001). Among patients with a history of myocardial infarction, NSAIDs were commonly prescribed in ambulatory settings, being included in 70.7% of prescriptions for musculoskeletal diseases compared to 43.5% for respiratory diseases.
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