NSAID Use During Acute Respiratory Infection Linked to Increased Heart Attack Risk

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) during acute respiratory infections (ARI) could increase the risk of myocardial infarction (MI), according to the results of a recent study.

Risk of gastrointestinal hemorrhage associated with the use of NSAIDs has been well established, but recent research has also called attention to the potential cardiovascular risks associated with use of the common pain relievers. Further, previous studies have drawn associations between ARI and MI risk.
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In order to examine the combined effects of NSAID and ARI exposure on risk of MI, researchers conducted a case-crossover study of 9793 patients who were hospitalized for MI from 2007 to 2011 in Taiwan. Using data from a national health insurance program, the researchers compared MI risk among patients with ARI and NSAID exposure, ARI without NSAID use, NSAID use only, or neither ARI or NSAID use.

Overall, oral NSAID use during ARI was associated with a 3.4-fold increased risk for MI compared with no exposure. ARI without NSAID use was associated with a 2.7-fold increased risk for MI, and NSAID use alone was associated with a 1.5-fold increased risk of MI, compared with no exposure. Parenteral NSAID delivery in patients with ARI was associated with 7.2-fold increased risk of MI, compared with no exposure.

Based on the findings, the researchers recommend that physicians use caution and consider patients’ history and the potential risks before prescribing NSAIDs to patients with ARI.

—Michael Potts

Reference:

Warren-Gash C, Udell JA. Respiratory tract infections, nonsteroidal anti-inflammatory drugs and acute myocardial infarction: is understanding interaction between risk factors the key to personalizing prevention? [published online February 1, 2017]. J Infect Dis. doi: doi.org/10.1093/infdis/jiw604.