Key result
Rheumatic disease is linked to ~3.5-fold higher odds of continued NSAID use at HF discharge.
Why the study?
NSAIDs are potentially inappropriate medications for patients with HF and can cause adverse events, motivating an examination of factors associated with continuing NSAID prescriptions at hospital discharge.
Does the continuation of NSAIDs at discharge increase the risk of readmission in patients hospitalized for heart failure?
Cohort (n=36,085)
Yes
Does the continuation of NSAIDs at discharge increase the risk of readmission in patients hospitalized for heart failure?
Odds Ratio: 3.47 (95% CI 3.16–3.82)
Continuation of NSAIDs at discharge in heart failure patients is strongly driven by comorbidities like rheumatic disease and is associated with significantly higher 1-year all-cause readmission rates.
Rheumatic disease flags high-risk NSAID continuation in HF; observational data leaves open whether targeted interventions improve discharge prescribing.
Non-steroidal anti-inflammatory drugs (NSAIDs) are potentially inappropriate medications for patients with heart failure (HF) and may cause adverse events through the “triple-whammy” mechanism. We examined the factors associated with the continuation of NSAIDs prescriptions at hospital discharge among patients with HF. Using data from the Japanese Registry of All Cardiac and Vascular Disease and Diagnosis Procedure Combination from April 2020 to March 2023, we analyzed 36,085 patients with HF who received NSAIDs during hospitalization. Patients were categorized as continuing or discontinuing NSAIDs at discharge. Multivariate logistic regression was performed to identify factors associated with continued NSAIDs use, including age, sex, comorbidities, and number of hospital beds. Among patients with HF who were prescribed NSAIDs, 53.4% were concomitantly prescribed a renin angiotensin agent and a diuretic. Rheumatic disease (OR: 3.47; 95% CI 3.16–3.82) showed the strongest association with continued NSAIDs use, while chronic kidney disease (OR: 0.90; 95% CI 0.84–0.96) was negatively associated. Smaller hospital size (< 450 beds) was positively (OR: 1.16; 95% CI 1.10–1.22) correlated with continued NSAIDs prescriptions. A substantial proportion of patients with HF are exposed to triple-whammy drug combinations. These findings can help optimize drug therapy in patients with HF who continue NSAIDs prescriptions.
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Sunaga et al. (2026) conducted a cohort in Heart failure (n=36,085). Rheumatic disease vs. Absence of rheumatic disease was evaluated on Continued NSAIDs use at discharge (OR 3.47, 95% CI 3.16-3.82). Among patients hospitalized for heart failure, rheumatic disease was the strongest factor associated with continued NSAID use at discharge (OR 3.47), alongside older age, female sex, and smaller hospital size.
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