New research has confirmed a link between NSAIDs and the risk of acute myocardial infarction – with increased risk on immediate exposure to the anti-inflammatory medications.
The meta-analysis of almost 500,000 individuals including 61,460 with acute MI found an increase in risk from both traditional NSAIDs and COX-2 inhibitors within the first week.
The odds ratio for MI ranged from celecoxib (1.24), ibuprofen (1.48) diclofenac (1.50), and naproxen (1.53) to rofecoxib (1.58), and was dose-dependent.
“Short term use for 8-30 days at a high daily dose (celecoxib >200 mg, diclofenac >100 mg, ibuprofen >1200 mg, and naproxen >750mg) is associated with the greatest harms, without obvious further increases in risk beyond the first 30 days,” said the authors of the study published in The BMJ.
Professor Danny Liew, co-director of the Monash Centre of Cardiovascular Research and Education in Therapeutics, told the limbic the findings confirm and add to the body of evidence for elevated risk of MI with NSAIDs.
“The important thing for people to realise is that the increase in relative risk of MI might be within the initial period of use.”
“We already have an understanding of their limited role from a safety point of view. The potential for adverse effects from these drugs is not disputed in terms of bleeding, GI ulceration and fluid excess. This is yet another thing to consider when determining risk versus benefit.”