Photo Credit: Liudmila
The following is a summary of “Generation of Risk Score for Serious Non-Steroidal Anti-Inflammatory Drug (NSAID) Induced Cardiovascular Events (NAÏVE) Among Active-Duty Service Members and Veterans,” published in the March 2025 issue of Journal of Pain Research by Atkinson et al.
An evidence-based tool was created to evaluate the likelihood of nonsteroidal anti-inflammatory drugs (NSAID)-induced cardiovascular events (NAÏVE), aiding clinicians in enhancing safe pain management, especially for individuals at higher cardiovascular risk.
Researchers conducted a retrospective study to develop the NSAID Induced NAÏVE risk scoring tool for estimating the likelihood of serious cardiovascular events linked to NSAID use.
They utilized the Data Analysis and Visualization Initiative (DAVINCI) database, integrating electronic health records, administrative data, and clinical data from both the Veterans Health Administration (VHA) and the Department of Defense (DoD). The study included individuals with at least 1 NSAID pharmacy claim, identifying cases as those who experienced non-fatal myocardial infarction, non-fatal stroke, or new heart failure. The NAÏVE risk scoring tool was developed by analyzing demographic, clinical, and prescription-related factors, including NSAID exposure, comorbidities, and medication history. The primary outcome was the first occurrence of a cardiovascular event.
The results showed that 2,31,967 cases and 23,19,670 controls were identified from individuals with at least 1 NSAID pharmacy claim between October 1, 2016, and September 30, 2020. The NAÏVE risk index exhibited strong discriminatory ability and calibration, with a C-statistic of 0.88. Higher odds of NSAID-induced cardiovascular events were linked to factors such as age, NSAID exposure, comorbidities, and medication history.
Investigators concluded that NAÏVE, the first evidence-based NSAID cardiovascular risk score, provided clinicians valuable decision support, facilitating shared decision-making, though further validation was needed.
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