Common Pain Killer Linked to Increase Heart Attack Risk
Regular use of non-steroidal anti-inflammatory drugs (NSAIDs), even for as little as a week and especially at higher doses, could increase the risk of myocardial infarction (MI), according to a recent study.
Previous research has suggested an increased risk of MI with both traditional and COX 2 selective NSAIDs, but the effects of treatment duration, dosage, and the type of NSAID is less well understood.
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The researchers conducted a systematic review and meta-analysis of studies including 446,763 participants from Canada, Finland, and the United Kingdom, 61,460 of which experienced MI.
Researchers focused on celecoxib, diclofenac, ibuprofen, naproxen, and rofecoxib in their analysis.
The researchers found that taking any dose of any NSAID for 1 week, 1 month, or more than 1 month was associated with increased risk of MI, with naproxen having the same associated risk as traditional NSAIDs. Celecoxib had a lower risk than rofecoxib, and was comparable to traditional NSAIDs. Overall, the risk of MI in individuals taking NSAIDs was increased 20% to 50% compared with those not taking NSAIDs.
The risk was greatest among those using higher doses and during the first month of use. Longer treatment duration was not associated with further increases in risk, however, the researchers cautioned that they did not evaluate repeat MI in participants.
“Given that the onset of risk of acute myocardial infarction occurred in the first week and appeared greatest in the first month of treatment with higher doses, prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses.”
—Michael Potts
References:
- Bally M, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data [published online May 9, 2017]. BMJ. www.bmj.com/content/357/bmj.j1909.
- Heightened risk of heart attacks found with common painkillers in routine use [press release]. May 10, 2017. CRCHUM. http://crchum.chumontreal.qc.ca/en/news-briefs/heightened-risk-heart-attacks-found-common-painkillers-routine-use.