PT  - JOURNAL ARTICLE
AU  - Schmidt, Morten
AU  - Hováth-Puhó, Erzsébet
AU  - Christiansen, Christian Fynbo
AU  - Petersen, Karin L.
AU  - Bøtker, Hans Erik
AU  - Sørensen, Henrik Toft
TI  - Preadmission use of nonaspirin nonsteroidal anti-inflammatory drugs and 30-day stroke mortality
AID  - 10.1212/WNL.0000000000001024
DP  - 2014 Nov 25
TA  - Neurology
PG  - 2013--2022
VI  - 83
IP  - 22
4099  - http://n.neurology.org/content/83/22/2013.short
4100  - http://n.neurology.org/content/83/22/2013.full
SO  - Neurology2014 Nov 25; 83
AB  - Objectives: To examine whether preadmission use of nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) influenced 30-day stroke mortality.Methods: We conducted a nationwide population-based cohort study. Using medical databases, we identified all first-time stroke hospitalizations in Denmark between 2004 and 2012 (n = 100,043) and subsequent mortality. We categorized NSAID use as current (prescription redemption within 60 days before hospital admission), former, and nonuse. Current use was further classified as new or long-term use. Cox regression was used to compute hazard ratios (HRs) of death within 30 days, controlling for potential confounding through multivariable adjustment and propensity score matching.Results: The adjusted HR of death for ischemic stroke was 1.19 (95% confidence interval [CI]: 1.02–1.38) for current users of selective cyclooxygenase (COX)-2 inhibitors compared with nonusers, driven by the effect among new users (1.42, 95% CI: 1.14–1.77). Comparing the different COX-2 inhibitors, the HR was driven by new use of older traditional COX-2 inhibitors (1.42, 95% CI: 1.14–1.78) among which it was 1.53 (95% CI: 1.02–2.28) for etodolac and 1.28 (95% CI: 0.98–1.68) for diclofenac. The propensity score–matched analysis supported the association between older COX-2 inhibitors and ischemic stroke mortality. There was no association for former users. Mortality from intracerebral hemorrhage was not associated with use of nonselective NSAIDs or COX-2 inhibitors.Conclusions: Preadmission use of COX-2 inhibitors was associated with increased 30-day mortality after ischemic stroke, but not hemorrhagic stroke. Use of nonselective NSAIDs at time of admission was not associated with mortality from ischemic stroke or intracerebral hemorrhage.CI=confidence interval; COPD=chronic obstructive pulmonary disease; COX=cyclooxygenase; DNRP=Danish National Registry of Patients; HR=hazard ratio; ICD=International Classification of Diseases; ICH=intracerebral hemorrhage; NSAID=nonsteroidal anti-inflammatory drug; PGE2=prostaglandin E2; SAH=subarachnoid hemorrhage