Study reveals all non-steroidal anti-inflammatory drugs (NSAIDs) are linked to risk of myocardial infarction
A new study has concluded that all NSAIDs were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.
“This new research on NSAIDs reinforces what physicians know already, that patients should use the smallest possible dose for the shortest possible time. But for most patients, the risk is very small,” said the lead researcher, Dr Michelle Bally.
“If you average people with different baseline heart risks, the risk specifically due to an NSAID is only about 1% per year, so out of 100 people treated continuously for a year, there will be one extra heart attack.”
The elevated MI risk linked to NSAIDs is thought to be related to the selective inhibition of the COX-2 enzyme, which may increase blood pressure.
In addition to prescribing the smallest amount of NSAIDs and for the shortest possible time, physicians should counsel patients to learn their cardiac risks, said Dr Bally.
“They should get a good idea of what their baseline risk of a heart attack is and decide if they want to use these drugs or not.”
However, the overall risk is small for most patients, she noted. It’s also important to be aware of the risks of taking opioids as an alternative to relieve pain, said Dr Bally.
Patients may want to consider nondrug approaches to address their pain. Such approaches could include topical analgesics, exercise, or physiotherapy.
But for most patients, the risk is very small, she noted. “If you average people with different baseline heart risks, the risk specifically due to an NSAID is only about 1% per year, so out of 100 people treated continuously for a year, there will be one extra heart attack.”