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January 1987

Nonsteroidal Anti-inflammatory Drugs as a Prognostic Factor in Acute Pulmonary Edema

Author Affiliations

Nijmegen, the Netherlands

Arch Intern Med. 1987;147(1):176-179. doi:10.1001/archinte.1987.00370010174040

To the Editor.  —We read with interest the article by Goldberger et al that was published in the March 1986 issue of the Archives.1 In 106 admissions, the precipitant factor of acute pulmonary edema and the outcome of the illness have been studied by chart review and either telephone contact with the patients or analysis of questionnaires mailed to patients who could not be reached by telephone. Details of the patient's medical history and preadmission medication were presented, but therapy with nonsteroidal antiinflammatory drugs (NSAIDs) was not specifically mentioned. Occasionally, therapy with NSAIDs induces congestive heart failure by solute retention,2 or by blunting the diuretic response to furosemide therapy.3 Today, NSAID therapy is administered widely to an impressive part of the elderly population.4,5We screened the records of 600 patients with congestive heart failure, consecutively admitted to the Department of Medicine of our hospital, in an attempt to

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