Even short-term NSAID use might be risky in cardiac patients
In patients who have previously had a heart attack (myocardial infarction / MI), most nonsteroidal anti-inflammatory drugs (NSAIDs), even when only taken for a week, have been associated with increased risk of death and recurrent heart attacks.
The study, published on May 9 2011 in Circulation, found that use of NSAIDs was associated with a 45% increased risk of death or recurrent MI in the first 7 days of use and 55% increased risk if patients continued taking NSAIDS.
“We found that short-term treatment with most NSAIDs was associated with increased and instantaneous cardiovascular risk” said one of the authors. “Results indicate that there is no apparent safe therapeutic window for NSAIDs in patients with prior MI and challenge the current recommendations of low-dose and short-term use of NSAIDs as being safe”.
Some NSAIDs were associated with more risk than others, but none were shown to be completely safe. Researchers could not identify a period that appeared to be safe, no matter how little time they were taken. Patients were taking commonly available / prescribed medication like ibuprofen and diclofenac as well as COX-2 inhibitors like Vioxx and celecoxib. Diclofenac was associated with early and higher cardiovascular risk than Vioxx (withdrawn in 2004 because of its high cardiovascular risk).
All NSAIDs, except naproxen, were associated with an increased risk for death or recurrent MI, diclofenac had the worst risk.
So, if you know anyone who has had a heart attack, make sure they are aware of the risks of even small doses of NSAIDs like ibuprofen – which is commonly taken for headaches, back and neck pain and tendinitis.
Cardiovascular Risk Associated With NSAIDs and COX-2 Inhibitors.Perry, Mosler et al. US Pharmacist. 2014;39(3):35-38.
Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study BMJ 2016; 354 doi: http://dx.doi.org/10.1136/bmj.i4857 (Published 28 September 2016)