Nsaids increase risk of second heart attack; diclofenac the worst


Nsaids increase risk of second heart attack; diclofenac the worst

It has often been thought in recent decades that simple home remedies such as ibuprofen can help cure all, assist with back pain and even treat heart attack. However, in a new study it has been found that even short-term use of a popular type of painkiller may be dangerous for people who have had a heart attack. Heart attack survivors who were prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) were 45% more likely to die or have another heart attack within one week of treatment.

International guidelines discourage the use of these painkillers in people with established heart disease. If NSAID treatment is unavoidable, recommendations call for the shortest duration of NSAID use possible.

Nonsteroidal anti-inflammatory drugs are the most prescribed medications for treating conditions such as arthritis. Most people are familiar with over-the-counter, nonprescription NSAIDs, such as aspirin and ibuprofen.

NSAIDs are more than just pain relievers. They also help reduce inflammation and lower fevers. They prevent blood from clotting, which is good in some cases but not so beneficial in others.

Anne-Marie Schjerning Olsen, MB, research fellow at Copenhagen University in Hellerup, Denmark states:

"Our results indicate that there is no apparent safe therapeutic window for NSAIDs in patients with prior heart attack."

Risks were determined and associated with treatment with NSAIDs anti-inflammatory drugs in 83,675 Danish adults who had had their first heart attack between 1997 and 2006. About 42% of the heart attack survivors studied had been prescribed at least one NSAID. The most commonly prescribed NSAIDs in the study were ibuprofen (23%), diclofenac (13.4%), rofecoxib, recalled in 2004, (4.7%), and celecoxib (4.8%).

Elliott Antman, MD, who wrote a 2007 American Heart Association NSAIDs advisory continues:

"This research that adds to our knowledge about the adverse effects of NSAID use in patients with coronary artery disease. The authors further confirm our prior practical advice that NSAID use should be avoided and if unavoidable should be used at the smallest doses for the shortest time possible. Naproxen has not been shown to have an increased cardiovascular risk and may be safer than other NSAIDs."

Further, the results showed the use of NSAIDs was associated with an overall 45% higher risk of death or recurrent heart attack within a week of treatment. This risk rose to 55% within three months of treatment.

Diclofenac in particular was the most harmful. Users were three times more likely to die or have a repeat heart attack within one week of use. The FDA recently issued a warning stating that diclofenac should not be used by people for pain in the time period surrounding heart bypass surgery.

Diclofenac can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking diclofenac. Older adults may have an even greater risk of these serious gastrointestinal side effects.

The NSAID naproxen was not associated with an increased risk of death or heart attack. Naproxen is used to treat pain or inflammation caused by conditions such as arthritis, ankylosing spondylitis, tendinitis, bursitis, gout, or menstrual cramps.

Source: Circulation: An American Heart Association Journal

High Doses of Common Painkillers Increase Heart Attack Risk (Video Medical And Professional 2020).

Section Issues On Medicine: Cardiology