The Association of Non-steroidal Anti-inflammatory Medications and Carotid Artery Intima-media Thickness in Male Veteran Twins Open Access

Song, Chao (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/tq57nr41t?locale=en
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Abstract

Objective: NSAID use is common and may increase cardiovascular risk through vascular mechanisms. We studied the relationship between NSAID use and carotid IMT in a sample of middle-aged veteran twins.

Methods: We studied 318 middle-aged male twins (159 pairs) aged 47-60 years were recruited from the Vietnam Era Twin Registry for the study. Common carotid artery intima-media thickness (cIMT) was measured using high resolution B-mode ultrasonography. Generalized estimating equation (GEE) models to adjust for possible confounding.

Results: The twins who took NSAIDs, on average, had a 17.8 µm greater carotid IMT than his twin who did not use NSAID (95% CI -4.5-40.0; monozygotic: 9.8, 95% CI -9.8-29.4; dizygotic 95.9, 95% CI: 59.8-132.0). Compared with twins who used aspirin, twins who non-aspirin NSAIDs had more significantly greater carotid IMT. The carotid IMT of twins who used non-aspirin NSAIDs was, on average, 31.7 µm higher than carotid IMT for his twin brother who did not (95% CI 1.7-62.7; monozygotic: 37.3, 95% CI 7.4-67.2; dizygotic 102.3, 95% CI: 56.3-148.3), while the carotid IMT of twins who used aspirin was, on average, 10.3 µm higher than carotid IMT for his twin brother who did not (95% CI -15.4-35.9; monozygotic: -7.0, 95% CI -32.4-18.4; dizygotic 93.2, 95% CI: 48.9-137.6).

Conclusion: Among middle-aged Vietnam era veterans, NSAID use was associated with carotid intima-media thickness. This suggests that NSAIDS may increase CVD risk through vascular mechanisms. These findings may help future efforts to evaluate and treat NSAID-related cardiovascular effects.

Table of Contents

Background and Literature Review 1

Study Objective and Research Questions 2

Methods 1

Study population 1

Measurement 1

Statistics 2

Results 4

Strengths and Weaknesses 10

Acknowledgements 12

Reference 13

Tables 18

Table 1. Measurements of variables 18

Table 2. The Dosage Level of NSAIDs 19

Table 3. Selected Characteristics by NSAIDs use, Emory Twins Study (n=318) 20

Table 4. The Association of Mean carotid IMT differences and NSAID use (n=292 individuals, 86 discordant MZ pairs, and 60 discordant DZ pairs) 21

Table 5. The Association of Mean carotid IMT differences and aspirin and non-aspirin NSAID (n=292 individuals, 86 discordant MZ pairs, and 60 discordant DZ pairs) 22

Table 6. The Association of Mean carotid IMT differences and Unselective/ Selective NSAIDs (n=292 individuals, 86 discordant MZ pairs, and 60 discordant DZ pairs) 23

Table 7. The Association of Mean carotid IMT Differences and Non-aspirin NSAIDs by dose (n=292 individuals, 86 discordant MZ pairs, and 60 discordant DZ pairs) 24

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