Everett Chiropractic Center Blog

May 12, 2017

All NSAIDs Linked to Increased MI Risk: Medscape Article

Published in Medline, by Pauline Anderson, May 10, 2017

Use of nonsteroidal anti-inflammatory drugs (NSAIDs), including naproxen, considered by some as one of the safest drugs in this class, is associated with a significantly increased risk for myocardial infarction (MI), results of a new patient-level meta-analysis show.

The analysis showed the heightened MI risk occurred as early as the first week of use and the risk was greater 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,” Michèle Bally, PhD, an epidemiologist in the Department of Pharmacy and Research Center, Centre hospitalier de l’Université de Montréal, Quebec, Canada, told Medscape Medical News.

Even though the research suggests the increased MI risk lessened over time, “the findings were not conclusive enough about longer duration,” said Dr Bally.

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.”

The research was published online May 3 in BMJ.

Although previous studies have linked both traditional and cyclooxygenase-2 (COX-2) selective NSAIDs to increased MI risk, the timing of the risk, the effect of dose and treatment duration, and the comparative risks between different drugs are poorly understood, the researchers note.

The recently reported Prospective Randomized Evaluation of Celecoxib Integrated Safety Vs Ibuprofen Or Naproxen (PRECISION) study found that at moderate doses, celecoxib was noninferior to ibuprofen or naproxen with regard to cardiovascular safety.

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