In patients with MI, NSAIDs may increase the risk of MI, death during the course of treatment
TUESDAY, May 10 (HealthDay News) -- In patients with prior myocardial infarction (MI), even short-term treatment with most nonsteroidal anti-inflammatory drugs (NSAIDs) may be associated with an increased risk of recurrent MI and death, according to a study published online May 9 in Circulation.
Anne-Marie Schjerning Olsen, from the the Copenhagen University Hospital in Denmark, and colleagues investigated the relationship between the duration of NSAID treatment and MI cardiovascular risk in 83,675 patients in Denmark. NSAID use was identified in patients aged 30 years or older who were admitted with first-time MI between 1997 and 2006. Of the 42.3 percent who received NSAIDs during follow-up, the risk of death and recurrent MI was analyzed according to NSAID treatment duration and by incidence rates per 1,000 person-years.
The investigators identified 35,257 deaths and recurrent MIs. NSAID treatment was significantly correlated with an elevated death/recurrent MI risk both at the beginning of treatment (hazard ratio [HR], 1.45) and throughout the course of the treatment (HR, 1.55 after 90 days). Individual NSAID analyses revealed that diclofenac was correlated with the highest risk of death/MI between day one and day seven of treatment (HR, 3.26).
"This nationwide study of patients with prior MI demonstrated that short-term treatment with most NSAIDs is associated with increased cardiovascular risk. Notably, commonly used NSAIDs, such as diclofenac, which in some countries is available over the counter without any expert advice on potential side effects, were associated with increased risk treatment onset, and the risk continued to persist during the course of treatment," the authors write.