People who use commonly prescribed non-steroidal anti-inflammatory drugs (NSAIDs) to treat pain and inflammation could be raising their risk of having a heart attack, as early as in the first week of use and especially within the first month of taking high doses of such medication, suggests a study in The BMJ this week.
Doctors and patients urged to weigh the risks and benefits of ibuprofen, diclofenac, celecoxib, and naproxen
Previous studies suggested that both traditional and COX 2 selective NSAIDs could increase the risk of acute myocardial infarction (heart attack), but the timing of the risk, the effect of dose, treatment duration, and the comparative risks between NSAIDs were poorly understood.
An international team of researchers led by Michèle Bally of the University of Montreal Hospital Research Center (CRCHUM), then an epidemiology doctoral student at McGill University in Canada, set out to characterise the risks of heart attack associated with use of oral NSAIDs under real life practice circumstances.
For their study, the researchers carried out a systematic review and a meta-analysis of relevant studies from various healthcare databases including those from Canada, Finland and the United Kingdom.
Collectively, they analysed results on 446,763 people of whom 61,460 had a heart attack.
The NSAIDs of interest to the researchers were celecoxib, the three main traditional NSAIDs (diclofenac, ibuprofen, and naproxen), and rofecoxib. To provide guidance, the researchers presented their results as probabilities of having a heart attack. They looked at various scenarios corresponding to how people might routinely use these drugs.
The study found that taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of heart attack. Naproxen was associated with the same risk of heart attack as that documented for other NSAIDs. With celecoxib, the risk was lower than for rofecoxib (Vioxx) and was comparable to that of traditional NSAIDs.
Source: Medical Xpress
