NSAIDs and heart attacks: More bark than bite

Related articles

A startling headline warns that patients may be at risk of heart attack or death following even short-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs). But before you start tossing out bottles from your medicine cabinet, know that the study researchers acknowledge that not all NSAIDs are implicated. For example, naproxen (Aleve), was not associated with a greater risk of recurrent heart attack or death.

For the study, published in the journal Ciruclation, Anne-Marie Schjerning Olsen and colleagues analyzed data from the Danish National Patient Registry and a national prescription registry of more than 83,500 patients who had suffered from a previous heart attack. Of this patient population, 42 percent had at least one prescription for an NSAID. Those who used certain types of NSAIDs for one week had a 45 percent increased risk of another heart attack. The figure jumped to 55 percent if the drug was used for three months. Of the NSAIDs studied, diclofenac had the worst risk profile, with a threefold increase in cardiovascular risk — worse than Merck’s Vioxx, which was withdrawn in 2004.

According to Ms. Olsen, “There is no apparent safe therapeutic window for NSAIDs in patients with prior [heart attack].”

ACSH's Dr. Josh Bloom concurs. “These are very important findings, and the whole issue of NSAID choice and risk will have to be carefully revisited.”