NSAID use tied to higher risk of cardiovascular events

Commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of heart attack, stroke, and death, according to a meta-analysis published January 11 in British Medical Journal, HealthDay News reported.

Sven Trelle, MD, of the University of Bern (Switzerland), and colleagues analyzed 31 randomized controlled trials comparing the cardiovascular safety of any NSAID treatment with other NSAIDs or placebo in 116,429 patients. Patients were treated with naproxen, ibuprofen, diclofenac, celecoxib, etoricoxib, rofecoxib, lumiracoxib, or placebo.

The number of harmful outcomes overall was low, according to researchers. However, compared with placebo, there were risks associated with NSAIDs. Rofecoxib and lumiracoxib were associated with the highest risks of myocardial infarction (rate ratios 2.12 and 2.00, respectively), ibuprofen and diclofenac with the highest risk of stroke (rate ratios 3.36 and 2.86, respectively), and etoricoxib and diclofenac with the highest risk of cardiovascular death (rate ratios 4.07 and 3.98, respectively).

“Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms,” researchers wrote. “Cardiovascular risk needs to be taken into account when prescribing any NSAID.”